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M. Khuthaila, J. Wang, J. C. Chen, J. Galic; Therapeutic Outcomes in Retinal Angiomatous Proliferation. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4553.
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To assess treatment response of retinal angiomatous proliferation (RAP).
fifty-nine consecutive patients with the diagnosis of RAP were identified from a private retina practice. All patients had baseline clinical examination, optical coherence tomography (Stratus III OCT, Zeiss Humphrey, Dublin, CA) fluorescein angiography, and some patients also had indocyanine green angiography (HRA2, Heidelberg Engineering, Germany). Patients underwent various treatment modalities including photodynamic therapy (PDT), intravitreal injection (triamcinolone acetonide, bevacizumab, pegaptanib), thermal laser photocoagulation, and a combination of these treatments. All patients had at least one follow-up OCT. Patients’ response to different treatment modalities was assessed by visual acuity and OCT changes. The timing and the rate of recurrence of RAP within one-year period were also assessed.
A total of 61 eyes (53 patients) were included in the study. All patients had at least 3 months follow-up (range: 3 -50 months). Twenty-five (41%) of 61 eyes had longer than 12-month follow-up. Ten eyes (17%) obtained visual improvement greater than two Snellen lines; forty-seven eyes (60%) had stable vision with changes within one Snellen line; worsening of vision occurred in 14 (23%) eyes. Three-month follow OCT was available in 29 of 61 (48%) eyes. Anatomical improvement as assessed by OCT was evident in 24 (83%) eyes; 5 (17%) eyes did not respond to treatment. Twenty-five eyes had more than 12-month follow-up after the initial positive response to treatment. Of these, 7 (28%) eyes had no recurrence at one-year follow-up, and 18 (72%) had recurrences within the first year. The average time to 1st recurrence was 25 weeks (range: 12 - 52 weeks). The average rate of recurrence among these 25 eyes is 1.2 per year.
We have found that some patients with RAP respond well to treatment - especially a combination of different treatment modalities. The merit of combination therapy in the treatment of RAP will be discussed.
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