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F. Betis, P. Gastaud; Ranibizumab (Lucentis) Treatment in Patients With Retinal Angiomatous Proliferation. Interest of Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5251.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the anatomical outcome with Spectral Domain Optical coherence tomography (OCT), and fonctionnal outcome, after injection of ranibizumab in eyes with retinal angiomatous proliferation (RAP).
Retrospective case series. Thirteen eyes of 13 consecutive patients with visual loss due to RAP underwent 3 intravitreal injections of 0,5 mg (0.05 ml) ranibizumab (Lucentis, Novartis) at six weeks interval. Best corrected visual acuity testing, OCT imaging with the Spectralis HRA-OCT device (Heidelberg, Germany) were performed at baseline and at each follow-up visit, performed 4 weeks after each injection. Fluorescein and ICG-angiography were performed at baseline and at the end of the treatment. Tomographic components of RAP were: at the level of anastomosis, break of both RPE and outer plexiform layer between witch was present an hemorragic pigmented area as a water jet; around the anastomosis, inner nuclear layer oedema, serous retinal detachment and moderate and irregular RPE uprinsing.
Mean visual acuity pre-injection was 0,31 +/- 0,19 logMAR (n = 14). Far vision increased significantly by a mean of 0.57 +/- 0,76 lines (n = 14) after the firts injection, 1.57 +/- 2.14 lines (n = 14) after the second injection (p = 0.004) and 1.50 +/- 1.51 lines ( n = 14) after the third injection (p = 0.004). Central retinal thickness decreased from 410+/- 108 microm to 270+/-44 microm after the third injection (p = 0.005). Complete tomographic normalisation of RAP was observed in 10 cases and was caracterized by: around the anastomosis, decrease of sub- and intra- retinal components; at the level of the anastomosis, RPE layer healing, loss of photoreceptors with atraction and adhesion of outer plexiform layer to RPE. No adverse events were observed.
Intravitreal ranibizumab (Lucentis) resulted in a regression of intra- and subretinal exsudative components and an increase in visual acuity. Spectral Domain Optical coherence tomography can efficiently evaluate healing of retinal angiomatous proliferation and the results of treatment, providing great assistance in indications for treatment and retreatment.
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