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Retinal angiomatous proliferation: is intravitreal ranibizumab therapy enough?
Author(s) -
MARJANOVIC B,
GEORGOUDIS P,
MANDAL K,
PATRA S
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.3316.x
Subject(s) - medicine , ranibizumab , visual acuity , ophthalmology , photodynamic therapy , stage (stratigraphy) , retinal , macular degeneration , combination therapy , surgery , bevacizumab , chemotherapy , paleontology , chemistry , organic chemistry , biology
Purpose To report the use of Ranibizumab monotherapy versus Ranibizumab combined with additional photodynamic therapy (PDT) in the management of retinal angiomatous proliferation (RAP). Methods The data from a non‐randomised series of 25 patients with RAP lesions attending the Bristol Eye Hospital age‐related macular degeneration (AMD) treatment clinic from April to October 2008 was analysed. The RAP lesions were classified according to Yannuzzi’s system as stage 1, 2 or 3 based on clinical, ocular coherence tomogram and angiographic features. Two treatment regimes were identified (1) Lucentis monotherapy and (2) Lucentis monotherapy with additional photodynamic therapy (PDT). The main outcome measures were the % of eyes losing < 15 letters, % of eyes gaining ≥ 15 letters and the mean change in visual acuity. Results Mean LogMAR visual acuity was 52.8 letters before treatment. Mean follow‐up time is 9.5 months. Fourteen eyes had been treated with PDT before or after the use of Ranibizumab. Two eyes received PDT+IVT only (Stage 2 patients). 77% of eyes had an improvement in visual acuity. 18.5 % of eyes have had improvement of 15 or more letters. Mean change in visual acuity was +7.2 letters. 57% and 60% of patients with stage 1 & 2 disease respectively, received PDT. Conclusion Combined therapy is effective in improving visual acuity and reducing central retinal thickness (CRT) in all patients with stage 1 lesions and most of patients with stage 2 lesions. Combined therapy offered greater gain in visual acuity in all treated patients. Stage 1 and 2 patients benefit more from the treatment if the condition is recognised and treated early.