Retinal angiomatous Proliferations- does the treatment outcome depend on the stage? A retrospective follow-up

Abstract

Purpose : Retinal angiomatous proliferations (RAP) are classified as a subtype of neovascular age related macula degenerations (nAMD). The prevalence of RAP lesions is 10-15% in Caucasians and 5% in Asians. RAP lesions are categorized in three stages with a subdivision in IIA and IIB. The treatment of RAP with Anti-VEGF agents has often been described as not as successful as in other types of nAMD. Our aim was to find out whether treatment outcome with Ranibizumab differed among the three stages of RAP.

Methods : 36 patients with diagnosed retinal angiomatous proliferation were evaluated. Best corrected visual acuity (BCVA) was obtained before, during and after upload with Ranibizumab. Data among the four stages (with specification in IIA and IIB) were compared.

Results : Rap lesions in stage I and IIA responded better to treatment than later stages. RAP type I had a gain of 2.0 lines (1^st injection 0 lines, 2^nd + 3^rd injection + 0.80 lines) , RAP type IIA and type IIB lost 0.21 lines (1^st injection: +0,75 lines, 2^nd injection: -0,46 lines, 3^rd injection: +0,29 lines) and 0.90 lines (1^st injection: +0,22 lines, 2^nd injection: -0,49 lines, 3^rd injection: +0,33 lines) respectively and RAP type III lost 1.12 lines (1^st injection: -0,05 lines, 2^nd injection: -0,33 lines, 3^rd injection: -0,26 lines) after 3 injections.

Conclusions : RAP lesions regardless of stage do not respond well to treatment. Earlier types of RAP seem to have a better outcome than late stages, which appear to result in a poor treatment outcome. Consequently patients suffering from this special subtype profit from an early identification and an early treatment

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.