Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Abstract

Purpose To assess the 1-year functional outcome and to evaluate the morphological changes after intravitreal injections of ranibizumab in eyes affected with retinal angiomatous proliferation (RAP) due to age-related macular degeneration (AMD). Methods A prospective, non-randomized, interventional study was conducted on 26 consecutive patients with newly diagnosed RAP. All eyes were treatment naive and were randomized to receive intravitreal injections of ranibizumab for a 12-month period. After the first three monthly injections, re-treatment was performed in case of best-corrected visual acuity (BCVA) loss of at least five letters associated with fluid within the macula, central macular thickness (CMT) increase of at least 100 lm, and/or persistence of fluid within the macula as evaluated by optical coherence tomography, new onset macular haemorrhages, persistence of leakage from the lesions on fluorescein angiography. Results All patients completed the 12-month follow-up: 25 of the 29 treated eyes (86.2%) were stabilized, with a loss of less than 15 letters. Nineteen eyes (65.5%) maintained or improved their BCVA, and three eyes (10.3%) gained three lines or more. Overall, mean BCVA remained stable at the 12-month follow-up (À0.07 letters; P40.05). Mean CMT significantly decreased from 386 ± 147 to 216 ± 74 lm at the 12-month follow-up. No significant adverse events were observed during the study. The mean number of injections was 5.8±1.7 during the follow-up period. Conclusion The 1-year follow-up outcomes in our series suggest that ranibizumab is an effective treatment for RAP in AMD, allowing stabilization of BCVA and reduction of CMT.

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

“…The treatment of RAP using ranibizumab has also yielded promising results;11 12 however, few studies have reported the long-term functional and anatomical outcomes of intravitreal ranibizumab (IVR) in patients with RAP. Furthermore, a previous report concluded that geographic atrophy occurred frequently in patients with RAP after treatment 13.…”

One-Year Outcomes Comparing Anti-VEGF Monotherapy and Combined Anti-VEGF+Photodynamic Therapy for Retinal Angiomatous Proliferation

“…As demonstrated by studies in literature, anti-VEGF treatment either as a monotherapy or in combination with PDT, has proved to be an efficient method of preserving visual acuity and providing anatomical success (10)(11)(12)(13)(14)(16)(17)(18)(19). Our study also presented results with preserved visual acuity and improved macular anatomy.…”

“…travitreal antiangiogenic factor (anti-VEGF), which has been the principal method used for the last decade (10)(11)(12)). Anti-VEGF monotherapy can provide the necessary decrease in subretinal fluid, an active disease marker in clinical examination and optical coherence tomography (OCT), and also increase visual acuity (13).…”

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

“…However, the success rates are debatable. There are reports of worse outcome of RAP lesions [25][26][27][28][29] as well as outcomes comparable to other CNV lesion types [6,30,31].…”