Intravitreal Anti-Vascular Endothelial Growth Factor for Retinal Angiomatous Proliferation in Treatment-Naive Eyes

Gharbiya, Magda; Parisi, Francesco; Cruciani, F; Bozzoni-Pantaleoni, Francesco; Pranno, Federica; Abdolrahimzadeh, Solmaz

doi:10.1097/iae.0b013e3182979e62

Cited by 41 publications

(44 citation statements)

References 19 publications

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“…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. The treatment regimen - PRN - and other limitations inherent in a clinical practice setting may also have influenced our end-points, and the mean number of injections/patient/year (2.2 ± 1.2) also suggests that our patients may have been undertreated.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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].…”

Section: Introductionmentioning

confidence: 99%

“…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]. …”

Section: Introductionmentioning

confidence: 99%

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

Marques

Gil

et al. 2015

Ophthalmic Res

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Purpose: To evaluate the long-term efficacy of ranibizumab in the treatment of retinal angiomatous proliferation (RAP) and to identify predictors of functional outcome. Methods: Retrospective case series comprised 79 eyes of 68 consecutive patients with RAP followed up ≥36 months. Primary end-points were best-corrected visual acuity (BCVA) and central macular thickness (CMT) variation at 36 months and at the last visit. Results: Mean follow-up time was 59.8 ± 16.0 months. All eyes were treated with pro re nata ranibizumab, with (n = 33) or without (n = 46) photodynamic therapy (PDT). Stabilization or improvement in BCVA was observed in 50.6% of the patients at 36 months, and in 40.5% at the end of the follow-up, where 20.3% preserved reading vision. A significant decrease in CMT was observed at 36 months (p < 0.001), but not at the end of the follow-up. Geographic atrophy (GA) was present in 59.5% of the eyes at the final visit. Baseline subretinal fluid was associated with better visual outcomes (p = 0.001). Results of combination treatment with intravitreal ranibizumab and PDT did not significantly differ from ranibizumab monotherapy. Conclusion: Modest functional outcomes can be expected from the long-term treatment of RAP lesions in clinical practice, most likely due to the advent of GA. Baseline subretinal fluid positively correlated with final BCVA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Marques

Gil

et al. 2015

Ophthalmic Res

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“…Anti-VEGF therapy (as monotherapy or in combination with PDT) seems to offer rather favorable results. In most cases however, despite the rapid initial response, repeated injections are needed due to frequent relapses [8-11]. Relapse rate and long-term visual outcome have been proposed to correlate with the disease stage, since late stages are related with poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results of Combination Treatment with Single-Dose Ranibizumab plus Photodynamic Therapy for Retinal Angiomatous Proliferation

Malamos¹,

Tservakis²,

Kanakis³

et al. 2018

Ophthalmologica

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Purpose: To present functional and anatomic outcomes of combination therapy with ranibizumab and photodynamic therapy (PDT) in a series of retinal angiomatous proliferation (RAP) cases. Methods: A total of 17 eyes of 17 patients with RAP were included. Thirteen eyes were treatment naïve and 4 were already on ranibizumab monotherapy. Combined treatment with single-dose ranibizumab and PDT was performed on all treatment-naïve cases. Follow-up was performed every month for 6–38 months, using optical coherence tomography and indocyanine green angiography when necessary. Results: Overall, 6 out of 7 treatment-naïve cases with stage I or II disease manifested complete angiographic resolution of the hot spot with a single injection of ranibizumab plus PDT. In stage III disease, 7 out of 10 eyes showed persistent leakage immediately after the combined treatment. The rate of hot spot occlusion was found to correlate with the stage of disease (p = 0.05). There was a significant improvement in posttreatment BCVA for all patients regardless of disease stage (p = 0.02), which was more evident in the earlier stages. Improvement was also greater for treatment-naïve patients (p = 0.03). The posttreatment improvement in BCVA was strongly correlated with hot spot occlusion (p < 0.001). Conclusions: Single-dose modified anti-VEGF treatment in combination with PDT may provide long-term regression at the initial stages of RAP.

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Long-term visual outcome and prognostic factors of Intravitreal anti-vascular endothelial growth factor treatment for retinal angiomatous proliferation

Cho

Lee

Han

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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Intravitreal Anti-Vascular Endothelial Growth Factor for Retinal Angiomatous Proliferation in Treatment-Naive Eyes

Abstract: Intravitreal anti-vascular endothelial growth factor monotherapy was a valid option for retinal angiomatous proliferation. Stable or improved visual acuity was obtained in 95% and 100% of eyes at 2 years and 3 years, respectively.

Cited by 41 publications

References 19 publications

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

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

Long-Term Results of Combination Treatment with Single-Dose Ranibizumab plus Photodynamic Therapy for Retinal Angiomatous Proliferation

Long-term visual outcome and prognostic factors of Intravitreal anti-vascular endothelial growth factor treatment for retinal angiomatous proliferation

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