Intravitreal Ranibizumab (Lucentis®) for the treatment of Retinal Angiomatous Proliferation - Clinical identification is too late

Abstract

Purpose: : Retinal Angiomatous Proliferations (RAP) are a subgroup of exsudative Age-related Macular Degeneration (AMD) with devastating reduction of visual acuity later on. To test wether intravitreal Ranibizumab provides a good therapy for this sort of neovascularization was the question of this investigation.

Methods: : Data of 25 patients with clinically identified retinal angiomatous proliferation stage III were retrospectively evaluated. Best-corrected visual acuity (BCVA) was obtained before, during and after upload with intravitreal Ranibizumab. Data were compared to groups of occult, minimally classic and predominantly classic CNV with similar visual acuity at the time of diagnosis.

Results: : In the time between indication and first injection the visual acuity decreases regardless of the type of neovascularization. During upload there is no improvement any more up to the first control visit 4 weeks after the third injection in the RAP group (1^st injection: -0.70 lines; 2^nd injection: -0.72; 3^rd injection: -0.51; 1^st control: -0.55 lines), but an increase in visual acuity in all other types (averages values over all other groups: 1^st injection: -0.30 lines; 2^nd injection: +0.56; 3^rd injection: +1,01; 1^st control: +1,05 lines).

Conclusions: : Treatment of patients with a late stage retinal angiomatous proliferation with Ranibizumab is effective as stabilization of visual acuity can be achieved. But in contrast to other forms of exsudative AMD there is no further improvement as it is known from other forms. Therefore, patients with this special form need to be identified and treated as early as possible.

Keywords: age-related macular degeneration