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Elizabeth M Walsh, Sumith Perera, Ramez Borbara, Gabriella De Salvo; Outcomes in Eyes with Retinal Angiomatous Proliferation treated with different anti-VEGF regimens. Invest. Ophthalmol. Vis. Sci. 2018;59(9):834. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the demographics of patients diagnosed with Retinal Angiomatous Proliferation (RAP) and visual and morphologic outcomes on different anti-Vascular Endothelial Growth Factor (anti-VEGF) drugs.
Retrospective study including patients diagnosed with RAP between 2013 - 2017. Review of demographic information, best corrected visual acuity (BCVA), fluorescein angiography, indocyanine angiography, spectral domain optical coherence tomography (SD-OCT), and anti-VEGF-treatment received. Patients were split into three groups: Aflibercept group, Ranibizumab group and those whose treatment was switched. Baseline characteristics included Reticular Pseudodrusen (RPD), Pigmented Epithelial Detachment (PED) and central macular thickness (CMT) measured at SD-OCT.
45 eyes of 38 patients were included in the study, of which 26 were from females and 19 were from males. Mean age at diagnosis was 84 years. RPD was seen in 21 eyes from female patients (81%) and 17 from males (89%), while PED was seen in 9 females (35%) and 13 males (68%). The 13 eyes from males with PED also had RPD, but PED and RPD appeared to be mutually exclusive in our female sample. Mean improvement in BCVA (logMAR) at 12 months was 0.8 (+0.4) in Aflibercept; 0.1 (+0.2) in Ranibizumab; and 0.2 (+0.2) at 12 months post-switch in the switch group (p=0.78). The mean improvement in CMT at the same time frame was -173μm (+118) in Aflibercept, -50μm (+114) in Ranibizumab and -5μm (+21) in the switch group (p=0.03). There was no significant difference in the average number of injections for those treated with Aflibercept (n=7) or Ranibizumab (n=8) (p=0.97), but there was when comparing these groups with the switch group (n=16 p<0.05).
Males and females were most likely to develop RAP in their 80s. Those with RAP were highly likely to have RPD, and if male, those with RPD were highly likely to have PED. The mean improvement in BCVA at 12 months was greatest in the Aflibercept group, but was not statistically significant. The difference between groups in CMT reduction at 12 months was significant, but no one group had a significant reduction overall.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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