Abstract
Purpose: :
To report the results of retinal angiomatous proliferation (RAP) treatment using subtenon injection of Anecortave combined with PDT.
Methods: :
This is a prospective review of consecutive patients with age-related macular degeneration who underwent treatment of RAP from June 1, 2006, through June 1, 2008. Inclusion criteria were: no previous treatment and diagnosis of RAP at stage 2-3 based on dynamic indocyanine green angiography (ICGA) and fluorescein angiography (FA). Patients received a subtenon injection of Anecortave followed by PDT after 15 days. Follow-up visits were scheduled every months with visual acuity (ETDRS charts), FA and ICGA. Decision for retreatment was based upon worsening of leakage on angiography and/or decreased visual acuity. Retreatment protocol included a PDT every three months. All patients underwent a repeated injection of Anecortave after six months.
Results: :
Ten patients (10 eyes) with stage 2 RAP (6 eyes) and with stage 3 RAP (4 eyes) were identified. Ten patients were followed for at least six months and 4 patients for 12 months.During injection of Anecortave blooding and reflux occurred in 3 patients each.At six months, a functional improvement (> = 2 lines) was achieved in 3 Patients: 2 at stage 2 and 1 stage 3. A steady state was recorded in 5 patients (3 at stage 2 and 2 at stage 3) and decreased vision (<= 2 lines) occurred in 2 patients: 1 at stage 2 and 1 at stage 3.Anatomically, all the lesions remained perfused after treatment.Only 4 patients were seen after 12 months of follow-up, so the results are still preliminary.
Conclusions: :
Six months results after combined treatment of Anecortave-PDT seem to be promising with 8 out of 10 patients showing a stable or improved functional outcome. We are waiting for results at 12 months of follow-up.
Keywords: age-related macular degeneration • corticosteroids • photodynamic therapy