Abstract
Purpose: :
To report the 12 and 24 months results of the intravitreal bevacizumab treatment for retinal angiomatous proliferation (RAP).
Methods: :
In this retrospective study, 74 consecutive patients (83 eyes) with RAP lesions were included who underwent intravitreal bevacizumab injections between September 2005 and February 2007. Ocular examination included visual acuity (VA) measurement, fundus photography and optical coherence tomography. Fluorescein angiography was available at baseline and was repeated if necessary. Indocyanine green angiography was performed if the RAP lesions could not be graded with certainty. Primary outcome measurement was the change of the mean VA from baseline to 12 and 24 month. VA equivalents were converted into logMAR units for statistical analysis.
Results: :
In a total, 74 patients (52 female, 22 male, mean age: 78.3 years) were treated by intravitreal bevacizumab injections (average 3.2 for 12 month and 2.2 for the second year). Eighty three eyes (group 1) passed the 12 months follow-up and 40 eyes (group 2) completed 24 months examination. In the group 1, the mean VA was 0.63± 0.26 at baseline and 0.65 ± 0.37 at 12 month (P=0.84). In the group 2, the mean VA changed from 0.69 ±0.25 at baseline to 0.66±0.36 at 12 months (P=1.00) and to 0.66±0.38 in 24 months (P=0.99). Their final change of VA correlated significantly with the change seen within the first year (P<0.01).VA increased by 2 or more ETDRS lines in 31.3% (26/83) of the eyes in 12 months and in 29.2% (12/41) in 24 month. Decrease of the VA of 2 or more ETDRS lines was seen in 33.7% (28/83) eyes and in 36.5% (15/41) in 24 months. Four eyes had pigment epithelial tears, one eye prolonged intraocular inflammation and another eye retinal detachment not related to the injection.
Conclusions: :
The presented study showed that every two of the three patients with RAP lesions had the chance to maintain or improve the baseline VA by at least two lines after the intravitreal bevacizumab treatment. This effect was seen at 12 month examination and maintained through the 24 months. Intravitreal bevacizumab injections seem to be a treatment option for the eyes wit RAP lesions.
Keywords: age-related macular degeneration • vascular endothelial growth factor • choroid: neovascularization