April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Treatment of Retinal Angiomatous Proliferation with Intravitreal Anti-VEGF Drugs in Real Life Practice
Author Affiliations & Notes
  • Maurizio Battaglia Parodi
    Department of Ophthalmology, Scientific Institute San Raffaele, Milano, Italy
  • Simone Donati
    Department of Surgical and Morphological Sciences, Section of Ophthalmology, University of Insubria, Varese, Italy
  • Claudio Azzolini
    Department of Surgical and Morphological Sciences, Section of Ophthalmology, University of Insubria, Varese, Italy
  • Alfredo Pece
    Department of Ophthalmology, Melegnano Hospital, Milano, Italy
  • Ferdinando Bottoni
    Eye Clinic, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan, Milano, Italy
  • Paola Danzi
    Ophthalmology Clinic, Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, University of Brescia, Brescia, Italy
  • Ugo Introini
    Department of Ophthalmology, Scientific Institute San Raffaele, Milano, Italy
  • Vincenzo Pucci
    Department of Ophthalmology, Desenzano del Garda Hospital, Desenzano del Garda, Italy
  • Francesco Semeraro
    Ophthalmology Clinic, Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, University of Brescia, Brescia, Italy
  • Francesco Viola
    Department of Clinical Sciences and Community Health, Cà Granda, University of Milan, Milano, Italy
  • Footnotes
    Commercial Relationships Maurizio Parodi, None; Simone Donati, None; Claudio Azzolini, None; Alfredo Pece, None; Ferdinando Bottoni, None; Paola Danzi, None; Ugo Introini, None; Vincenzo Pucci, None; Francesco Semeraro, None; Francesco Viola, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4972. doi:
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      Maurizio Battaglia Parodi, Simone Donati, Claudio Azzolini, Alfredo Pece, Ferdinando Bottoni, Paola Danzi, Ugo Introini, Vincenzo Pucci, Francesco Semeraro, Francesco Viola, ; Treatment of Retinal Angiomatous Proliferation with Intravitreal Anti-VEGF Drugs in Real Life Practice. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4972.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate the outcomes of intravitreal anti-VEGF in the treatment of retinal angiomatous proliferation (RAP) in real life practice.

Methods: The design of the study is a retrospective, interventional, multicentre, case series. All the charts of patients affected by RAP, regularly followed up and treated with anti-VEGF drugs over 12 months were examined. All the patients underwent, both at baseline and over the follow-up, a monthly complete ophthalmologic examination, including best corrected visual acuity (BCVA) on ETDRS charts, fluorescein angiography, indocyanine green angiography, and ocular coherence tomography. Both intravitreal injections of ranibizumab and bevacizumab were considered for the study. After an initial loading phase of three consecutive injections, further re-treatments were administered on the basis of the identification of persistence or recurrence of subretinal/intraretinal fluid. The main outcome measure was the change in the mean BCVA at the 12-month examination. Secondary outomes included the proportion of eyes gaining at least 3 ETDRS lines, the mean change in the central retinal thickness (CRT), and number of injections at the end of the follow-up.

Results: Sixty-one eyes of 61 patients were considered for the study. Overall, the mean BCVA changed from 0.62, to 0.47 LogMAR (p: 0.004) at the 12-month examination. Seventeen eyes (28%) gained at least 3 ETDRS lines, whereas no eye lost more than 3 ETDRS lines, over the follow-up. Mean CRT passed from 333μm to 222μm (p < 0.001). Twenty-three eyes (37%) showed serous pigment epithelium detachment (PED) at baseline, which was still visible in 10 eyes (16%) at the end of the follow-up. No difference in BCVA gain was registered comparing ranibizumab and bevacizumab. Pigment epithelium detachment was detectable in 5% and 30% of the eyes, treated with ranibizumab and bevacizumab, respectively (p: 0.01). Mean number of injection was 4 and 4.6 in ranibizumab and bevacizumab subgroups, respectively.

Conclusions: Intravitreal anti-VEGF therapy can ensure a visual function improvement in about one third of patients affected by RAP, who are treated in the common clinical practice. Ranibizumab treatment requires less injections and more frequently leads to a pigment epithelium detachment resolution.

Keywords: 412 age-related macular degeneration • 453 choroid: neovascularization  
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