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E. Cappello, C. Battista, A. Romani, M. Zemella; Combined Therapy for Retinal Angiomatous Proliferation. Invest. Ophthalmol. Vis. Sci. 2008;49(13):552.
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To evaluate the results of a retrospective interventional case series of 27 eyes with RAP treated with a combined therapy with intravitreal Avastin and photodynamic therapy with verteporphin (PDT).
A complete ophthalmologic examination, BCVA measurement with ETDRS charts, dynamic fluorescein and indocyanine green angiography with stereo images were performed at baseline and at the follow-ups every three months. All patients received intravitreal injection of Avastin 0.04cc and PDT within 10 days. The need of retreatment was based on persistence of leakage by fluorescein angiography.
Twenty seven eyes with RAP at any stages were examined, the mean follow up was 7.5 months.18 eyes had stabilization of visual acuity (less than 3 ETDRS lines loss).In 6 eyes visual acuity improved.In 3 cases there was a visual loss of more than 3 ETDRS lines.
The term RAP describes a distinct form of exudative AMD with a very poor natural history. Several factors are involved on the pathogenesis of this disease, such as ischemia, oxidative stress, EPR damage and inflammation.Therefore it appears reasonable to treat the disease with combined therapies that have different and complementary active mechanisms to provide better results and a lower number of treatments.The combined therapy intravitreal Avastin and PDT seems to be effective in the treatment of RAP macular degeneration. The final visual acuity is correlated to the stage of the disease.
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