Treatment of Retinal Angiomatous Proliferation in Age-Related Macular Degeneration

Bottoni, Ferdinando; Massacesi, Amedeo; Cigada, Mario; Viola, Francesco; Musicco, Ilenia; Staurenghi, Giovanni

doi:10.1001/archopht.123.12.1644

Cited by 125 publications

(95 citation statements)

References 16 publications

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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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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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“…Previous reports indicate that treatment of RAP at earlier stages may lead to better anatomical and functional outcomes; when the vascular complex is well established, anatomical closure is difficult to achieve. 23 In conclusion, intravitreal anti-VEGF treatment with pegaptanib appears to have an effect on vision and CFT in patients with RAP. Against the background of a generally aggressive natural history, treatment appears to maintain function at 6 months in the majority of patients, although the effect appears to be limited and somewhat variable.…”

Section: Discussionmentioning

confidence: 84%

Early response of retinal angiomatous proliferation treated with intravitreal pegaptanib: a retrospective review

Mahmood

Kumar

Lenfestey

et al. 2008

Eye

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Aims To evaluate the early functional and anatomical responses to intravitreal pegaptanib in patients with retinal angiomatous proliferation (RAP). Methods Retrospective review of consecutive patients newly diagnosed with RAP treated with intravitreal pegaptanib (0.3 mg). Examination at baseline and 12 weekly intervals included refraction protocol best corrected visual acuity (BCVA), fluorescein angiography (FA), and optical coherence tomography (OCT). At intervening 6 weekly visits a reduced protocol assessment included BCVA and OCT. Results A total of 16 eyes of 16 patients (12 female, mean age 76.0 years) with RAP at baseline (15 stage 3, one stage 2) were treated. One patient had poor response, losing 20 ETDRS letters after one injection and was switched to photodynamic therapy combined with intravitreal triamcinolone. Mean BCVA (n ¼ 15) was baseline 45±11 (mean±SD) letters, 12 weeks 43±14 letters, 24 weeks 40 ± 14 letters; the reduction from baseline to 24 weeks was statistically significant (P ¼ 0.04). Vision remained stable defined as ± 15 letters of baseline BCVA in 13 (87%) of patients 2 (13%) lost 415 letters. Mean OCT central foveal thickness (CFT) (n ¼ 13) was: baseline 325±123 lm, 12 weeks 343±130 lm, 24 weeks 321±115 lm; difference at 24 weeks was not statistically significant (P ¼ 0.9). A pigment epithelial detachment was present in 12 cases; height was reduced in 10 cases at 24 weeks. Persistent leakage on FA was seen in 13 out of 15 cases at 24 weeks. Conclusion Early results of treatment of RAP with intravitreal pegaptanib suggest some stabilizing effect on this normally progressive disease.

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“…Se estima que pueden representar aproximadamente una cuarta parte de los pacientes con membranas ocultas (2,3). La edad media de estos pacientes es elevada (alrededor de 80 años) y tiene una marcada tendencia a la bilateralización (3)(4)(5).…”

Section: Discussionunclassified

Proliferación angiomatosa retiniana no relacionada con degeneración macular asociada a la edad: Buena respuesta al tratamiento con terapia fotodinámica

Torrón-Fernández-Blanco

Ferrer-Novella

Ruiz-Moreno

et al. 2008

Arch Soc Esp Oftalmol

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RESUMENCaso clínico: Varón de 55 años, sin drusas ni alteraciones del epitelio pigmentario sugestivas de degeneración macular asociada a la edad (DMAE), que presentó maculopatía exudativo-hemorrágica. La angiografía con fluoresceína e indocianina verde mostraron la proliferación angiomatosa retiniana (PAR), la arteriola aferente y vénula retinianas de drenaje. La respuesta fue óptima a un único tratamiento con terapia fotodinámica. Discusión: La PAR es una lesión descrita en los últimos años en el contexto de la DMAE, cuya principal característica es la lesión neovascular formada a partir de capilares retinianos y su extensión posterior al espacio subretiniano. Nuestro paciente presentaba los hallazgos típicos de PAR sin DMAE.Palabras clave: Proliferación angiomatosa retiniana, DMAE, desprendimiento neurosensorial, neovascularización coroidea, terapia fotodinámica. COMUNICACIÓN CORTA ABSTRACTCase: A 55-year-old male was diagnosed with exudative-hemorrhagic maculopathy, with no signs observed of drusen or pigmentary epithelium defects suggestive of age-related macular degeneration (ARMD). Fluorescein angiography (FA) and indocyanine green choroidal angiography (ICGA) showed retinal angiomatous proliferation (RAP). Afferent arteriole and retinal drainage venule connection was also observed. Treatment with a single Photodynamic Therapy provided an optimal outcome. Discussion: RAP is a form of neovascular ARMD described in recent years; it consists of an angiomatous proliferation that originates from the retinal capillary system and extends posteriorly into the subretinal space. Our patient showed typical RAP findings without any sign of ARMD (Arch Soc Esp Oftalmol 2008; 83: 121-124).

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Treatment of Retinal Angiomatous Proliferation in Age-Related Macular Degeneration

Cited by 125 publications

References 16 publications

Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Early response of retinal angiomatous proliferation treated with intravitreal pegaptanib: a retrospective review

Proliferación angiomatosa retiniana no relacionada con degeneración macular asociada a la edad: Buena respuesta al tratamiento con terapia fotodinámica

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