Ranibizumab in Retinal Angiomatous Proliferation (RAP): Influence of RAP Stage on Visual Outcome

Abstract

Patients in stage II without PED have a better visual and anatomic evolution than patients in stage II with PED and stage III.

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

“…Our study also presented results with preserved visual acuity and improved macular anatomy. Administered therapies appear to be more effective in treatment-naive cases 18 and cases with stage II lesions; both observed decrease in recurrences (16,20). In addition to the anatomically successful outcomes with anti-VEGF monotherapy noted by Arias et al (16) and in the present study, there are also findings indicating that PDT combined with anti-VEGF, triamcinolone, and other modalities were superior to anti-VEGF monotherapy (17)(18)(19).…”

“…Limitations of the present study are its retrospective design and the limited study group (n=15 eyes), but when compared to other studies in literature, sufficient data could be provided to achieve adequate results (16)(17)(18)(19)(20). It should also be emphasized that the uneven distribution of treatment-resistant cases may have had an effect on the results.…”

Treatment Effects in Retinal Angiomatous Proliferation Imaged with OCT Angiography

“…Anti-VEGF monotherapy yields promising results for early-stage RAP [7-12], but long-term outcome shows the necessity for repeated injections [8, 13-16]. Combination therapy seems to result in better visual outcome [17-22] and a lower retreatment rate [34, 35].…”

“…Monotherapy with intravitreal antivascular endothelial growth factor (anti-VEGF) injections shows favorable short-term results in several studies [7-12], but requires repeated administration and conflicting long-term outcomes have been reported [8, 13-16]. A combination treatment of intravitreal anti-VEGF or triamcinolone with photodynamic therapy (PDT) seems to lead to a rapid resolution of the consequences of RAP [17-22].…”

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].…”