Purchase this article with an account.
Felise May Barte, Michael D. Ober, Susan M. Malinowski; Raptrap: Reduction By Intravitreal Bevacizumab (avastintm) Preceding Thermal Laser Photocoagulation For The Treatment Of Retinal Angiomatous Proliferation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3534.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report our experience with the RAPTRAP protocol (Reduction by intravitreal bevacizumab (AvastinTM) preceding thermal laser photocoagulation) for the treatment of retinal angiomatous proliferation (RAP).
This is a retrospective analysis of vision and anatomic responses of patients with newly diagnosed, untreated RAP treated with RAPTRAP therapy- a novel combination of one intravitreal bevacizumab injection followed by one session of laser photocoagulation. A bevacizumab injection (1.25mg) was given within 2 weeks of diagnosis. Imaging was repeated within 3 weeks after injection and thermal laser was applied. All patients had a minimum 1year follow up.
Thirty three lesions of 26 patients received one RAPTRAP treatment. Patient mean age was 85 years (range: 68-93 yr). The average follow up was 20.3 months (12.2mo-44mo). Intravitreal bevacizumab was given an average of 8.8 days (range: 0-41d) following initial diagnosis. Laser ablation was performed an average of 3.4 weeks (range: 1.7-8weeks) following bevacizumab injection. Twenty lesions (60%) remained inactive throughout follow up (average 20.6 months). Thirteen lesions recurred after an average of 10.7 months. Ten of the 13 (77%) of the non-responding lesions became inactive after an average of 9.4 months following additional retreatment. Overall, mean best visual acuity on presentation was 20/70 and improved to 20/60 at the end of the study. 91% of both responders and non-responders had an improvement or stabilization in vision. Twenty five (76%) lesions had stable vision (+/- 3 lines of vision), 5 lesions (15%) had visual improvement (> 3 lines improvement), and 3 lesions (9%) had a decline (> 3 lines of loss) in vision. Mean central macular thickness decreased from 290 +/- 80um to 220 +/- 55um in all patients (p<0.001). There were no complications related to injections or laser treatments.
RAPTRAP treatment appears to offer long term anatomic and visual stability utilizing a less intrusive, non-repetitive and more cost effective method of treating RAP. Our results suggest additional controlled studies are warranted to further evaluate this new technique.
This PDF is available to Subscribers Only