Long-term results of intravitreal ranibizumab for the treatment of retinal angiomatous proliferation and utility of an advanced RPE analysis performed using spectral-domain optical coherence tomography

Abstract

The intravitreal injection of ranibizumab was effective for stabilising vision in patients with RAP, as evaluated at a 3-year follow-up examination. Advanced RPE analysis is useful for investigating atrophic areas after IVR. Visual acuity at baseline and progression of MA might be important for BCVA after IVR.

Long-Term Management of RAP Lesions in Clinical Practice: Treatment Efficacy and Predictors of Functional Improvement

“…Remarkably, in about one fifth of our population reading vision was preserved at the last visit. Other studies reported better BCVA results at 2- or 3-year follow-ups [18,19,20,24]. One possible explanation could be that the use of anti-VEGF agents in clinical practice rather than in a clinical trial setting [18,20] may lead to poorer than expected BCVA outcomes: the dependence on the resources and agenda of the clinical center may delay the initiation of treatment, protracting the gap between injections and subsequent follow-up.…”

“…Over the past years, the success rate of the various available treatments has been inconsistent. Nevertheless, some authors report relative stabilization of the disease with treatment, either PDT [13,14] or IV ranibizumab [18,19,21]. PDT was combined with IV ranibizumab [18,24] or even IV triamcinolone [18].…”

“…PDT was combined with IV ranibizumab [18,24] or even IV triamcinolone [18]. The maximal follow-up of studies on RAP treatment with IV ranibizumab with/without PDT was 3 years [18,19,20,21] and small sample sizes were small [18,19,24]. To our knowledge, this study combines the longest follow-up (59.8 ± 16.0 months, on average) with the largest sample size (n = 79) on RAP lesions treated with IV ranibizumab published to date.…”

“…While several treatment approaches proved unsuccessful in the past [13,14,15,16,17], the blockage of vascular endothelium growth factor (VEGF) has substantially changed the prognosis of this condition. Reports on intravitreal (IV) ranibizumab, either in monotherapy or with concomitant photodynamic therapy (PDT), have underlined the responsiveness of RAP lesions to both treatment modalities [18,19,20,21]. However, standard protocols for the management of the disease are currently not available [1], and published data are limited to small case series with short follow-up periods [18,19,20,21].…”

“…Reports on intravitreal (IV) ranibizumab, either in monotherapy or with concomitant photodynamic therapy (PDT), have underlined the responsiveness of RAP lesions to both treatment modalities [18,19,20,21]. However, standard protocols for the management of the disease are currently not available [1], and published data are limited to small case series with short follow-up periods [18,19,20,21]. …”