Ranibizumab for retinal angiomatous proliferation in neovascular age-related macular degeneration

Lai, Timothy Y. Y.; Chan, Wai‐Man; Liu, David T.; Lam, Dennis S.C.

doi:10.1007/s00417-007-0679-1

Cited by 44 publications

(31 citation statements)

References 10 publications

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“…22,40 A possible reason for that is the generally worse prognosis and the better therapeutical influence for the patients with classic CNV than for those with CNV without PED. In classic CNV, the intraretinal oedema and subretinal fluid is the major cause for visual decrease.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 In addition, the effectiveness of intravitreously injected VEGF inhibitors has been analysed in clinical studies. [20][21][22][23] However, the results of all the different therapeutic procedures have not been compared up to now. Therefore, the aim of this study was to evaluate the data of 328 patients suffering from exudative AMD with serous PED who received different treatment procedures.…”

Section: Introductionmentioning

confidence: 99%

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Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Lommatzsch

Heimes

Gutfleisch

et al. 2009

Eye

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Aims To investigate the therapeutic effects of different treatments on serous pigment epithelium detachment (PED) in age-related macular degeneration (AMD). Methods A total of 328 patients suffering from serous PED in AMD were retrospectively analysed. We treated only patients with documented visual deterioration: 86 patients with bevacizumab, 128 with ranibizumab, 60 with pegaptanib, and 54 with photodynamic therapy (PDT) combined with intravitreal triamcinolone acetonide (IVTA). Bestcorrected vision was determined in the logarithm of the minimal angle of resolution (logMAR). We also analysed morphological findings such as full foveal thickness by optical coherence tomography (OCT), manually calculated height of PED as measured by OCT, and fluorescence angiography. Results The mean follow-up was 42.4 weeks. The best-corrected visual acuity of 0.78 logMAR before treatment could be improved by about 0.066 logMAR after treatment. Retinal thickness decreased in all patients with PED, in the mean by about 64.06 lm, and the mean value of the manually calculated height decreased by about 0.98 units. All functional and morphological results proved to be significantly better after injection of ranibizumab and bevacizumab than after pegaptanib and the combined treatment with PDT and IVTA. In all, 41 (12.5%) of our patients developed a tear of the retinal pigment epithelium (RPE). Conclusion The therapeutic results were significantly better in patients treated with bevacizumab and ranibizumab than in those treated with pegaptanib or with a combination of PDT and IVTA. Even with treatment, tears of the RPE or only a partial flattening of the PED always indicated a worse prognosis in eyes with exudative AMD than in eyes with classic choroidal neovascularization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Lommatzsch

Heimes

Gutfleisch

et al. 2009

Eye

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“…4 A range of alternative treatment options have been reported in case series with limited evidence of efficacy. [5][6][7][8][9][10] No randomized controlled data have been published to date; the prognosis of RAP is currently considered to be poor.…”

Section: Introductionmentioning

confidence: 99%

Incidence of neovascularization in the fellow eye of patients with unilateral retinal angiomatous proliferation

Campa

Harding

Pearce

et al. 2010

Eye

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Aims The aim of this study is to describe the incidence and characteristics of neovascularization in the fellow eye of patients with retinal angiomatous proliferation (RAP). Methods This is a retrospective study conducted on all patients with a diagnosis of unilateral RAP commencing treatment in a single centre between November 2002 and January 2010. Clinical biomicroscopic examination, fluorescein angiography, and if required, indocyanine green angiography, and optical coherence tomography were used to evaluate all patients. Results In all, 37 patients had a follow-up of X1 year, 28 X2 years, and 11 X3. Patients who developed RAP in the fellow eye were: 2 of 37 (5.4%) within 1 year of follow-up, 4 of 28 (14.2%) within 2 years, and 4 of 11 (36.3%) within 3 years. Conclusion In our case series, the risk of neovascularization in the fellow eye of patients with unilateral RAP increased with time. Approximately one-third of patients with a 3-year follow-up developed a bilateral disease. Our findings warrant further large-scale investigation.

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“…Direct laser photocoagulation of the vascular lesion, laser photocoagulation of the feeder vessel, photodynamic therapy, and transpupillary thermotherapy rarely allow the anatomical closure of the lesion, especially once the vascular complex is well established. 9 Promising outcomes are expected from the use of anti-VEGF drugs, as shown by the short-term results of intravitreal pegaptanib sodium, 10 ranibizumab, 11,12 and bevacizumab 13 in the treatment of these lesions.…”

Section: Introductionmentioning

confidence: 99%

Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Atmani

Voigt

Tien

et al. 2010

Eye

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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.

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Ranibizumab for retinal angiomatous proliferation in neovascular age-related macular degeneration

Abstract: Intravitreal ranibizumab injections appeared to be an effective treatment for RAP, resulting in visual gain and reduction in macular thickness. Further long-term studies to evaluate the efficacy of intravitreal ranibizumab in RAP are warranted.

Cited by 44 publications

References 10 publications

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Incidence of neovascularization in the fellow eye of patients with unilateral retinal angiomatous proliferation

Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

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