Abstract
Purpose: :
Retinal angiomatous proliferation (RAP) is a distinct form of neovascular age-related macular degeneration, characterised by rapid deterioration of vision and poor prognosis. The effectiveness of anti-VEGF agents in prevention of severe visual loss and stabilization of visual acuity in wet macular degeneration has been proven in clinical trials. However the effectiveness of anti-VEGF agents in the management of RAP lesions has not been established.The aim of this study was to evaluate the effectiveness of intravitreal Ranibizumab (Lucentis) in patients with retinal angiomatous proliferation.
Methods: :
Retrospective review of patients diagnosed with RAP and currently undergoing treatment with intravitreal Ranibizumab (0.5 mg) since August 2007. Case notes were evaluated recording: LogMAR best corrected visual acuity (BCVA) pre treatment, 3, 6, 12, 18, 24 months post treatment, total number of injections and complications.
Results: :
A total of 88 eyes of 74 patients diagnosed with RAP were treated. The mean length of follow up was 13.41±6.6 (mean ± SD) months. On an average, 5.96±3.14 injections were given in 12 months and 7.41±4.37 injections in 24 months. Mean visual acuity at initial examination was 52.6±14.1 letters, while at 12 months 59.09±14.9 letters and at 24 months 53.8±20 letters. Patients gained an average of 6.5 and 1.2 letters at 12 and 24 months respectively. Mean cumulative probability of success (defined as ±15 letters of baseline BCVA) was 0.88 (95% CI: 0.8 to 0.97) at 12 months and 0.83 (95% CI: 0.6 to 1.06) at 24 months.
Conclusions: :
Intravitreal Ranibizumab treatment stabilized visual acuity in this normally progressive subtype of neovascular age-related macular degeneration, in our cohort of patients.
Keywords: age-related macular degeneration