Effect of photodynamic therapy (PDT), posterior subtenon injection of triamcinolone acetonide with PDT, and intravitreal injection of ranibizumab with PDT for retinal angiomatous proliferation

Nakano, Saya; Honda, Shigeru; Oh, Hideyasu; Kita, Mihori; Negi, Akira

doi:10.2147/opth.s29718

Cited by 4 publications

(12 citation statements)

References 31 publications

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“…The results are in agreement with the results reported in a number of studies on ranibizumab in monotherapy 18 – 20 , 27 or in combination with PDT. 24 , 28 , 29 In this sense, the observed functional improvement (VA) proved greater for the combination of ranibizumab plus PDT with verteporfin, while from the anatomical perspective (foveal thickness), the greatest reduction corresponded to the group administered ranibizumab in monotherapy. This finding differs from the observations of other studies in which functional and anatomical improvement showed the same trend.…”

Section: Discussionmentioning

confidence: 99%

Ranibizumab in monotherapy and combined with photodynamic therapy for retinal angiomatous proliferation

Arias¹,

Gómez‐Ulla²,

Ruiz-Moreno³

2016

OPTH

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PurposeTo compare the effects of intravitreal ranibizumab in monotherapy (group A) and combined with photodynamic therapy (PDT) with verteporfin (group B) in retinal angiomatous proliferation (RAP) treatment.MethodsThis was a multicentric, prospective, randomized clinical study conducted with parallel groups. The study eye in both groups received ranibizumab on days 1, 30, and 60 (loading dose); group B received PDT additionally on day 1. Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA) testing and optical coherence tomography were performed monthly, and fluorescein angiography and indocyanine green angiography were performed quarterly. Retreatment criteria were leakage in fluorescein angiography or indocyanine green angiography, mean foveal thickness increase ≥100 µm, or VA decrease ≥5 letters.ResultsTwenty patients were recruited (ten patients in each group). Six eyes had previous treatment (three eyes in group A and three eyes in group B), so only 14 eyes were naïve. At 12-month follow-up, mean VA improved +1.5 letters in group A and +5.6 letters in group B (analysis of variance test; P>0.05). Two patients (20%) in both groups gained ≥15 letters (chi-square test; P>0.05). Mean changes in greatest linear dimension and in foveal thickness were not statistically significant between groups of treatment (analysis of variance test; P>0.05). Mean retreatments per patient were 1.8 (group A) and 0.9 (group B) (Mann–Whitney U-test; P>0.05). One patient died due to underlying disease not related to study medication.ConclusionIntravitreal ranibizumab administered in monotherapy or combined with PDT was efficacious in terms of VA stabilization in patients with RAP.

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Section: Discussionmentioning

confidence: 99%

Ranibizumab in monotherapy and combined with photodynamic therapy for retinal angiomatous proliferation

Arias¹,

Gómez‐Ulla²,

Ruiz-Moreno³

2016

OPTH

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“…Of the 34 included studies, 24 reported on anti-VEGF therapy alone ( Engelbert et al, 2009 ; Montero et al, 2009 ; Atmani et al, 2010 ; Hemeida et al, 2010 ; Reche-Frutos et al, 2011 ; Parodi et al, 2013 ; Gharbiya et al, 2014 ; Inoue et al, 2014 ; Shin and Yu, 2014 ; Park and Roh, 2015 ; Cho et al, 2016 ; Matsumoto et al, 2016 ; Kim et al, 2017a ; Kim et al, 2017b ; Hata et al, 2017 ; Kim et al, 2018 ; Browning et al, 2019 ; Invernizzi et al, 2019 ; Kim et al, 2019 ; Maruyama-Inoue et al, 2019 ; Arias et al, 2020 ; Ernest et al, 2020 ; Kim, 2020 ; Kim et al, 2020 ), 8 reported on anti-VEGF therapy combined with PDT ( Saito et al, 2010 ; Lee et al, 2011 ; Nakano et al, 2012 ; Saito et al, 2012 ; Saito et al, 2013 ; Seidel et al, 2013 ; Saito et al, 2016 ; Malamos et al, 2018 ) and 2 studies compared anti-VEGF therapy alone versus combined with PDT. ( Rouvas et al, 2012 ; Arias et al, 2016 ).…”

Section: Resultsmentioning

confidence: 99%

“…Publication year ranged from 2010 to 2018. Of these 10 studies, 5 were retrospective ( Saito et al, 2010 ; Nakano et al, 2012 ; Saito et al, 2012 ; Saito et al, 2013 ; Saito et al, 2016 ), 3 were prospective ( Lee et al, 2011 ; Seidel et al, 2013 ; Malamos et al, 2018 ) and two were randomized trials. ( Rouvas et al, 2012 ; Arias et al, 2016 ).…”

Section: Resultsmentioning

confidence: 99%

Anti-vascular endothelial growth factor monotherapy or combined with verteporfin photodynamic therapy for retinal angiomatous proliferation: a systematic review with meta-analysis

et al. 2023

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Purpose: To assess functional and anatomical outcomes of intravitreal anti-Vascular Endothelial Growth Factor (anti-VEGF) monotherapy versus combined with verteporfin Photodynamic Therapy (PDT) for Retinal Angiomatous Proliferation (RAP).Methods: Studies reporting outcomes of intravitreal anti-VEGF monotherapy and/or in combination with verteporfin PDT in RAP eyes with a follow-up ≥ 12 months were searched. The primary outcome was the mean change in best corrected visual acuity (BCVA) at 12 months. Mean change in central macular thickness (CMT) and mean number of injections were considered as secondary outcomes. The mean difference (MD) between pre- and post-treatment values was calculated along with 95% Confidence Interval (95% CI). Meta-regressions were performed to assess the influence of anti-VEGF number of injections on BCVA and CMT outcomes.Results: Thirty-four studies were included. A mean gain of 5.16 letters (95% CI = 3.30–7.01) and 10.38 letters (95% CI = 8.02–12.75) was shown in the anti-VEGF group and combined group, respectively (anti-VEGF group vs. combined group, p < 0.01). A mean CMT reduction of 132.45 µm (95% CI = from −154.99 to −109.90) and 213.93 µm (95% CI = from −280.04 to −147.83) was shown in the anti-VEGF group and combined group, respectively (anti-VEGF group vs. combined group, p < 0.02). A mean of 4.9 injections (95% CI = 4.2–5.6) and 2.8 injections (95% CI = 1.3–4.4) were administered over a 12-month period in the anti-VEGF group and combined group, respectively. Meta-regression analyses showed no influence of injection number on visual and CMT outcomes. High heterogeneity was found across studies for both functional and anatomical outcomes.Conclusion: A combined approach with anti-VEGF and PDT could provide better functional and anatomical outcomes in RAP eyes compared with anti-VEGF monotherapy.

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“…Most of documented studies have recommended the application of intravitreal injection of anti-VEGF drug for treating RAP, which was considered as a form of exudative AMD [ 17 – 19 ]. Since inflammation was involved in the pathogenesis of RAP, recent research studies have shown the efficacy of intravitreal or periocular TA injection in the treatment of RAP [ 20 , 21 ]. In this case, the patient only received antibiotic and triamcinolone therapy in the early stage due to the severe systemic inflammatory reactions.…”

Section: Discussionmentioning

confidence: 99%

A Case of Chorioretinitis with Retinal Angiomatous Proliferation

Chen

Wei

Qian

et al. 2021

Case Reports in Ophthalmological Medicine

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A 48-year-old woman had an acute blurred vision in the right eye immediately after drainage of liver abscess. Her best corrected visual acuity (BCVA) was 8/400; fundus photography suggested the diagnosis of endogenous endophthalmitis with chorioretinitis and vitritis. Due to the bad systemic condition, a systemic antibiotic combined with periocular triamcinolone (TA) was carried out first. Inflammatory cells in the vitreous cavity were decreased after treatment; however, fundus fluorescein angiography (FFA) showed abnormal dilation and leakage of the capillaries and retinal-choroidal anastomose, supporting that there was retinal angiomatous proliferation (RAP). Vitreous interleukin-6 (IL-6) was only slightly elevated; the ratio of interleukin-10 (IL-10) and IL-6 was less than 1, and the etiological test was negative. After receiving intravitreal vancomycin injection combined with periocular TA injection, the patient’s BCVA was improved from 16/400 to 20/400 with a reduction in vitreous inflammatory cells. However, the patient’s RAP was progressed and her BCVA was dramatically decreased to count finger/30 cm. After intravitreal injection of ranibizumab, the patient’s BCVA was 5/400 with a significant shrink in lesions and absorption of hemorrhage, exudation, and fluid. Thus, we suggest that early anti-inflammatory treatment in conjunction with anti-VEGF may achieve a better prognosis in patients with inflammatory retinal angiomatous proliferation (RAP).

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Effect of photodynamic therapy (PDT), posterior subtenon injection of triamcinolone acetonide with PDT, and intravitreal injection of ranibizumab with PDT for retinal angiomatous proliferation

Cited by 4 publications

References 31 publications

Ranibizumab in monotherapy and combined with photodynamic therapy for retinal angiomatous proliferation

Ranibizumab in monotherapy and combined with photodynamic therapy for retinal angiomatous proliferation

Anti-vascular endothelial growth factor monotherapy or combined with verteporfin photodynamic therapy for retinal angiomatous proliferation: a systematic review with meta-analysis

A Case of Chorioretinitis with Retinal Angiomatous Proliferation

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