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T. M. Johnson; Phase I Study of Ranibizumab for Stage 1 or 2 RAP Lesions Secondary to AMD. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1801. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal angiomatous proliferations (RAP) are a form of primary intraretinal neovascularization that may occur in 10-15 % of patients with exudative macular degeneration. Patients present with cystoid retinal edema, intraretinal hemorrhages and a focal hot spot on static ICG imaging. Vascular endothelial growth factor is hypothesized to be a stimulate for the growth of RAP lesions. This study was designed to evaluate the safety and efficacy of ranibizumab in patients with stage I or II retinal angiomatous proliferation (RAP) lesions secondary to age-related macular degeneration (AMD).
A prospective interventional case series of patients with RAP was conducted. Patients were treated with monthly intravitreal injections of ranibizumab (0.5 mg) per the MARINA protocol. The primary outcome measure was ETDRS visual acuity. Secondary outcomes included exudation on clinical examination, development of retinal choroidal anastamoses and subretinal fibrosis, fluorescein and high speed ICG imaging and OCT 3 retinal thickness and volume.
8 patients ( mean age 29 years ) with a minimum of 6 month follow up have been treated. At baseline average VA was 20/63. All patients had clinical features of RAP that was confirmed on imaging to be stage I or II. Average OCT central retinal thickness at baseline was 296 µm. Visual acuity at 3 and 6 month averaged 20/32 ( p<0.05 compared to baseline ). At 3 and 6 months average OCT retinal thickness was 186 and 144 µm ( p<0.008 compared to baseline ). By 3 months all RAP lesions were closed on angiography. Thus far, no serious ocular or systemic adverse events have been reported in this study.
Ranibizumab appears to be efficacious in the treatment of stage I and II RAP lesions. No complications to therapy have been observed.
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