March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Comparison Of Different Treatments For Retinal Angiomatous Proliferation
Author Affiliations & Notes
  • Marta Oldani
    Eye Clinic, Department of Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Milan, Italy
  • Ferdinando Bottoni
    Eye Clinic, Department of Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Milan, Italy
  • Chiara M. Eandi
    Eye Clinic, University Torino, Torino, Italy
  • Camilla Alovisi
    Eye Clinic, University Torino, Torino, Italy
  • Mario Cigada
    Eye Clinic, Department of Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Milan, Italy
  • Giovanni Staurenghi
    Eye Clinic, Department of Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Milan, Italy
  • Footnotes
    Commercial Relationships  Marta Oldani, None; Ferdinando Bottoni, None; Chiara M. Eandi, None; Camilla Alovisi, None; Mario Cigada, None; Giovanni Staurenghi, Allergan, Inc., Glaxo Smith Kline, Heidelberg Engineering, OD-OS, Pfizer Ophthalmics (C), Canon, Optovue, Zeiss (S), Ocular Instruments, Inc. (P)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 5153. doi:
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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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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : 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).

Methods: : 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.

Results: : 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).

Conclusions: : 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.

Clinical Trial: : https://eudract.ema.europa.eu 2008-001468-34

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • choroid: neovascularization 
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