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Marta Oldani, Ferdinando Bottoni, Chiara M. Eandi, Camilla Alovisi, Mario Cigada, Giovanni Staurenghi; Comparison Of Different Treatments For Retinal Angiomatous Proliferation. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5153.
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To compare the efficacy of intravitreal triamcinolone with photodinamic therapy (PDT), intravitreal bevacizumab with PDT and intravitreal bevacizumab alone for the treatment of retinal angiomatous proliferation (RAP).
In this prospective study, 21 eyes of 21 patients with naïve retinal angiomatous proliferation stage II and III were randomly assigned to one of the following therapeutic options: group 1 (n=7) intravitreal triamcinolone plus PDT with retreatment every 3 months; group 2 (n=6) intravitreal bevacizumab plus PDT with retreatment every month for bevacizumab and every 3 months for PDT; group 3 (n=8) intravitreal bevacizumab with retreatment every month. Retreatment criteria were: decrease in visual acuity of more than 5 letters (ETDRS chart); persistence or recurrence of fluid in optical coherence tomography; presence of blood; and evidence of leakage in fluorescein angiography. Analysis of variance was performed to correlate final best-corrected visual acuity (BCVA) to baseline BCVA, stage of RAP lesion, type and number of treatments. Fisher’s exact test was used to correlate final perfusion of the RAP evaluated with dynamic indocianine angiography and type of treatment.
19 patients completed 12 months follow-up: 6 in group 1, 6 in group 2 and 7 in group 3. Improvement or stabilization of visual acuity was achieved in group 1 for 5 of 6 patients, in group 2 for 5 of 6 patients and in group 3 for all patients. Final central retinal thickness was reduced in all groups. Mean number of treatments was 1.8 (range 1-2) in group 1, 4.3 intravitreal bevacizumab (range 2-8) and 2.8 PDT (range 1.4) in group 2, 5 in group 3 (range 4-7). Final BCVA was significantly correlated with baseline BCVA (p=0.004), whereas it did not correlate with stage of RAP (p=0.8), type (p=0.88) and number of treatments (p=0.9 for intravitreal injection; p=0.2 for PDT). Perfusion of RAP lesion at 12 months was not correlated with the type of therapy (p=0.8).
There was no difference between the three therapeutic options in terms of final visual acuity, central retinal thickness and perfusion of RAP lesion. Group 1 needed less treatments than group 2 and 3.
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