Two-year results of combined intravitreal anti-VEGF agents and photodynamic therapy for retinal angiomatous proliferation

Saito, Masaaki; Iida, Tomohiro; Kano, Mariko

doi:10.1007/s10384-012-0215-7

Cited by 11 publications

(19 citation statements)

References 42 publications

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“…Other reports also underline this favorable initial response of RAP lesions to treatment [19,24,25]. The decrease in CMT between baseline and the 36-month follow-up was still statistically significant in our population.…”

Section: Discussionsupporting

confidence: 82%

“…Remarkably, in about one fifth of our population reading vision was preserved at the last visit. 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.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, some authors report relative stabilization of the disease with treatment, either PDT [13,14] or IV ranibizumab [18,19,21]. 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].…”

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%

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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: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…Combined treatment, rather than monotherapy, has been studied and recommended for RAP, in contrast to other forms of AMD. The combination of anti-VEGF with PDT has been the most popular therapeutic option [11, 21-23]. …”

Section: Discussionmentioning

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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Ranibizumab

Tridente¹

2013

Adverse Events With Biomedicines

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Two-year results of combined intravitreal anti-VEGF agents and photodynamic therapy for retinal angiomatous proliferation

Abstract: Combined anti-VEGF and PDT for RAP patients effectively maintained or improved VA and reduced exudation, without severe adverse events, over 24 months.

Cited by 11 publications

References 42 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

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