Intravitreal Bevacizumab (Avastin) Treatment of Retinal Angiomatous Proliferation

Ghazi, Nicola G.; Knape, Robert M.; Kirk, Tyler Q.; Tiedeman, James S.; Conway, Brian

doi:10.1097/iae.0b013e318162d982

Cited by 44 publications

(29 citation statements)

References 44 publications

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“…Ghazi et al (2008) also reported their short-term experience with intravitreal bevacizumab of RAP. They found stabilization of visual acuity and central retinal thickness after a single injection for at least 8 weeks, suggesting that an injection frequency of less than one per month may be sufficient (Ghazi et al 2008). Wolf et al (2008) retrospectively evaluated 82 eyes with RAP treated with intravitreal bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

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Intravitreal ranibizumab treatment of retinal angiomatous proliferation

Kramann

Schöpfer

Lorenz

et al. 2012

Acta Ophthalmologica

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ABSTRACT.Purpose: To determine the efficacy of intravitreal injections of ranibizumab in the treatment of retinal angiomatous proliferation (RAP) in neovascular agerelated macular degeneration. Methods: Retrospective, consecutive case series of 26 eyes (26 patients) treated with intravitreal injections of 0.5 mg ranibizumab for RAP. Patients received intravitreal injections at monthly intervals during upload phase for a 3-month period. Results: Mean visual acuity before treatment was 0.75 ± 0.38logMAR (mean ± SD, n = 26). In the upload phase, mean visual acuity improved 4 weeks after the initial injection to 0.6 ± 0.37logMAR (n = 26) and to 0.53 ± 0.34logMAR (n = 26) 4 weeks after the third monthly intravitreal injection of ranibizumab. The mean optical coherence tomography (OCT) central foveal thickness reduced from 345 ± 55 lm at baseline to 215 ± 87 lm at 3 months. In the maintenance phase, mean visual acuity after 6 months was 0.66 ± 0.38logMAR (n = 12) and 0.7 ± 0.37logMAR after 9 months (n = 6). The mean OCT central foveal thickness was 259 ± 59 lm (n = 13) at 6 months and 280 ± 127 lm (n = 6) at nine-month follow-up. Conclusion: Intravitreal ranibizumab resulted in an improvement of visual acuity 4 weeks after the first injection but was more pronounced after 3 months. A reduction in leakage and OCT central foveal thickness was seen 3 months after the commencement of treatment.

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Section: Discussionmentioning

confidence: 99%

“…More recently, promising results with off-label intravitreal bevacizumab have been reported (Joeres et al 2007;Meyerle et al 2007;Ghazi et al 2008). Combined intravitreal bevacizumab and PDT for RAP had a positive effect on RAP lesions (Saito et al 2008 (Lai et al 2007).…”

Section: Introductionmentioning

confidence: 97%

Intravitreal ranibizumab treatment of retinal angiomatous proliferation

Kramann

Schöpfer

Lorenz

et al. 2012

Acta Ophthalmologica

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“…Only with introduction of anti-vascular endothelial growth factor drugs (VEGF) the results are slightly more promising, both with Bevacizumab (Avastin ® ) [21][22][23] and Ranibizumab (Lucentis ® ) [24]. Still, RAP seems to be an aggressive form of neovascularization.…”

Section: Introductionmentioning

confidence: 99%

Late Stage III Retinal Angiomatous Proliferation with Retino-Choroidal Anastomosis do not Respond Well to Treatment with Ranibizumab (Lucentis®)

Matthé¹,

Sandner²,

Maaß³

2017

Int J Neurorehabilitation Eng

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Background: Retinal Angiomatous Proliferations (RAP) is a subgroup of exsudative or "wet" Age-related Macular Degeneration (wAMD) with devastating reduction of visual acuity in later stages. Intravitreal Ranibizumab provides a good therapy, but is considered to be not as effective in this class of neovascularization compared to choroidal neovascularization (CNV). We investigated the efficacy of Ranibizumab in late stage III RAP with retino-choroidal anastomosis compared to the outcome of CNV lesions.

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“…They show favourable outcomes but frequent intravitreal injections are expected. [13][14][15][16] A combination therapy of bevacizumab and PDT has been hypothesized as being promising for neovascular ARMD, especially by prolonging the intervals between repeated injections. 17 Recent reports seem to confirm that combined intravitreal bevacizumab and PDT effectively maintained or improved visual acuity also for RAP lesions.…”

Section: Introductionmentioning

confidence: 99%

“…Reductions of leakage, significant decrease in macular thickness and improvement or stabilization of visual acuity in about 90% of treated eyes were the common findings at the end of the follow-up. However, 30-50% of the treated eyes needed re-injection of bevacizumab within 3 months [13][14][15] and 70% after the 3 monthly scheduled injections. 16 Persistent lesion activity was noted in nearly all patients at the end of follow-up.…”

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confidence: 99%

Sequential combined treatment with intravitreal bevacizumab and photodynamic therapy for retinal angiomatous proliferation

Viola

Mapelli

Carducci

et al. 2010

Eye

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Purpose To study visual and anatomical outcomes of sequenced combined therapy using intravitreal bevacizumab followed by photodynamic therapy (PDT) in eyes with retinal angiomatous proliferation (RAP). Safety and rate of intravitreal injections were also evaluated. Methods We conducted a prospective non-comparative pilot study of consecutive patients newly diagnosed with RAP. PDT guided by indocyanine green (ICG) angiography was applied 8±2 days after the intravitreal bevacizumab (1.25 mg) injection. At baseline and every month after the injection, best-corrected visual acuity (BCVA) measurement, complete eye examination including dynamic fluorescein and ICG angiography, and optical coherence tomography (OCT) were performed. Results In all, 21 eyes of 18 patients with RAP were enrolled. The mean age was 77 (range 65-86) years. Mean visual acuity at baseline was 0.63 ± 0.25 logMAR. After treatment BCVA showed no statistically significant differences between each visit (P ¼ 0.10, ANOVA). At 9 months, the BCVA improved by three or more lines in three eyes (14%), remained stable in twelve eyes (57%), and worsened in six eyes (29%). Foveal thickness decreased significantly between baseline and all the follow-up visits (Po0.01, ANOVA). A total of 36 intravitreal injections were given during the study with a mean of 1.7 injections per eye (range 1-3 injections per eye). No ocular or systemic adverse events were reported.Conclusion A possible synergistic effect may arise from the combination of intravitreal bevacizumab with PDT for the treatment of RAP. These findings also suggest a possible benefit of combo therapy in the rate of intravitreal re-injections.

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Intravitreal Bevacizumab (Avastin) Treatment of Retinal Angiomatous Proliferation

Abstract: These short-term data suggest that bevacizumab is a viable treatment option for RAP in AMD. The initial treatment effect appears to be maintained for at least 8 weeks.

Cited by 44 publications

References 44 publications

Intravitreal ranibizumab treatment of retinal angiomatous proliferation

Intravitreal ranibizumab treatment of retinal angiomatous proliferation

Late Stage III Retinal Angiomatous Proliferation with Retino-Choroidal Anastomosis do not Respond Well to Treatment with Ranibizumab (Lucentis®)

Sequential combined treatment with intravitreal bevacizumab and photodynamic therapy for retinal angiomatous proliferation

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