Abstract
BackgroundRetinal angiomatous proliferation (RAP) has been known as a variant of exudative age-related macular degeneration (AMD) with a unfavorable prognosis. To evaluate the effect of ranibizumab administered initially as three loading doses for patients with various stages of RAP.MethodsA retrospective chart review of 40 patients (41 eyes) with RAP was conducted. The study divided patients into three groups of Group I (8 eyes in stage I), Group II (17eyes in stage II), and Group III (16 eyes in stage III). All patients received three initial monthly intravitreal injections (0.5 mg) of ranibizumab and were monitored monthly for 12 months. Reinjection of ranibizumab after three initial monthly doses was administered on as-needed basis. The main outcome measures were the change in the mean of best-corrected Snellen visual acuity (BCVA) and central macular thickness (CMT), and the total number of injections received during the 12 months.ResultsThe mean change in BCVA at 12 months was-0.286,-0.165, and-0.151 (logMAR) in Group I, II, and III, respectively. CMT was also reduced by a mean of 32.72 ± 56.75, 57.45 ± 56.48 and 148.37 ± 98.59 μm. The mean number of injections in Group I was significant lower than those in Group II and III (P < 0.001, P < 0.001, and P = 0.15 for Group I versus Group II, Group I versus Group III, and Group II versus Group III, respectively).ConclusionsThe 12-month follow-up outcomes suggest that three consecutive loading doses of intravitreal ranibizumab is an effective treatment on early stage (stage I) of RAP. Patients in stage I showed a significantly lower recurrence rate than patients in later stages.
Highlights
Retinal angiomatous proliferation (RAP) has been known as a variant of exudative age-related macular degeneration (AMD) with a unfavorable prognosis
We report our 1-year results of using intravitreal ranibizumab “loading dose” monotherapy for the treatment of RAP by investigating the change in vision, and foveal height on optical coherence tomography (OCT)
Inclusion criteria was age ≥ 55 years and the presence of a typical RAP lesion, including preretinal, intraretinal and/or subretinal hemorrhages with neovascularization in one of the three stages of RAP confirmed by high definition-optical coherence tomography (HD-OCT), fluorescein angiography (FA) and indocyanine green angiography (ICGA)
Summary
Retinal angiomatous proliferation (RAP) has been known as a variant of exudative age-related macular degeneration (AMD) with a unfavorable prognosis. Retinal angiomatous proliferation (RAP) has been described as a variant of exudative age-related macular degeneration (AMD). It was first described by Yannuzzi et al [1] in 2001 and has been differentiated into 3 stages based on clinical and angiographic observations: stage I, intraretinal neovascularization (IRN) with proliferation of intraretinal capillaries within the deep retinal layers, producing intraretinal and superficial retinal hemorrhages; stage II, subretinal neovascularization (SRN). The risk of neovascularization in the fellow eye is higher in patients with RAP than in those with other forms of neovascular AMD [4]. Different treatment modalities have been proposed for RAP such as conventional laser photocoagulation, transpupillary thermotherapy, surgical
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