Long-Term Management of RAP Lesions in Clinical Practice: Treatment Efficacy and Predictors of Functional Improvement

Ophthalmic Res. 2016;55(3):119-25. doi: 10.1159/000441797. Epub 2015 Dec 16.

Abstract

Purpose: To evaluate the long-term efficacy of ranibizumab in the treatment of retinal angiomatous proliferation (RAP) and to identify predictors of functional outcome.

Methods: Retrospective case series comprised 79 eyes of 68 consecutive patients with RAP followed up ≥36 months. Primary end-points were best-corrected visual acuity (BCVA) and central macular thickness (CMT) variation at 36 months and at the last visit.

Results: Mean follow-up time was 59.8 ± 16.0 months. All eyes were treated with pro re nata ranibizumab, with (n = 33) or without (n = 46) photodynamic therapy (PDT). Stabilization or improvement in BCVA was observed in 50.6% of the patients at 36 months, and in 40.5% at the end of the follow-up, where 20.3% preserved reading vision. A significant decrease in CMT was observed at 36 months (p < 0.001), but not at the end of the follow-up. Geographic atrophy (GA) was present in 59.5% of the eyes at the final visit. Baseline subretinal fluid was associated with better visual outcomes (p = 0.001). Results of combination treatment with intravitreal ranibizumab and PDT did not significantly differ from ranibizumab monotherapy.

Conclusion: Modest functional outcomes can be expected from the long-term treatment of RAP lesions in clinical practice, most likely due to the advent of GA. Baseline subretinal fluid positively correlated with final BCVA.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Angiogenesis Inhibitors / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Macular Degeneration / drug therapy
  • Male
  • Middle Aged
  • Ranibizumab / therapeutic use*
  • Retinal Neovascularization / drug therapy*
  • Retrospective Studies
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Ranibizumab