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Published in: BMC Ophthalmology 1/2015

Open Access 01-12-2015 | Research article

One year results of intravitreal ranibizumab monotherapy for retinal angiomatous proliferation: a comparative analysis based on disease stages

Authors: Young Gun Park, Young-Jung Roh

Published in: BMC Ophthalmology | Issue 1/2015

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Abstract

Background

Retinal angiomatous proliferation (RAP) has been known as a variant of exudative age-related macular degeneration (AMD) with a unfavorable prognosis. To evaluate the effect of ranibizumab administered initially as three loading doses for patients with various stages of RAP.

Methods

A retrospective chart review of 40 patients (41 eyes) with RAP was conducted. The study divided patients into three groups of Group I (8 eyes in stage I), Group II (17eyes in stage II), and Group III (16 eyes in stage III). All patients received three initial monthly intravitreal injections (0.5 mg) of ranibizumab and were monitored monthly for 12 months. Reinjection of ranibizumab after three initial monthly doses was administered on as-needed basis. The main outcome measures were the change in the mean of best-corrected Snellen visual acuity (BCVA) and central macular thickness (CMT), and the total number of injections received during the 12 months.

Results

The mean change in BCVA at 12 months was-0.286,-0.165, and-0.151 (logMAR) in Group I, II, and III, respectively. CMT was also reduced by a mean of 32.72 ± 56.75, 57.45 ± 56.48 and 148.37 ± 98.59 μm. The mean number of injections in Group I was significant lower than those in Group II and III (P < 0.001, P < 0.001, and P = 0.15 for Group I versus Group II, Group I versus Group III, and Group II versus Group III, respectively).

Conclusions

The 12-month follow-up outcomes suggest that three consecutive loading doses of intravitreal ranibizumab is an effective treatment on early stage (stage I) of RAP. Patients in stage I showed a significantly lower recurrence rate than patients in later stages.
Literature
1.
go back to reference Yannuzzi LA, Negrao S, Iida T, Carvalho C, Rodriguez-Coleman H, Slakter J, et al. Retinal angiomatous proliferation in age-related macular degeneration. Retina. 2001;21(5):416–34.CrossRefPubMed Yannuzzi LA, Negrao S, Iida T, Carvalho C, Rodriguez-Coleman H, Slakter J, et al. Retinal angiomatous proliferation in age-related macular degeneration. Retina. 2001;21(5):416–34.CrossRefPubMed
2.
go back to reference Freund KB, Ho IV, Barbazetto IA, Koizumi H, Laud K, Ferrara D, et al. Type 3 neovascularization: the expanded spectrum of retinal angiomatous proliferation. Retina. 2008;28(2):201–11.CrossRefPubMed Freund KB, Ho IV, Barbazetto IA, Koizumi H, Laud K, Ferrara D, et al. Type 3 neovascularization: the expanded spectrum of retinal angiomatous proliferation. Retina. 2008;28(2):201–11.CrossRefPubMed
3.
go back to reference Viola F, Massacesi A, Orzalesi N, Ratiglia R, Staurenghi G. Retinal angiomatous proliferation: natural history and progression of visual loss. Retina. 2009;29(6):732–9.CrossRefPubMed Viola F, Massacesi A, Orzalesi N, Ratiglia R, Staurenghi G. Retinal angiomatous proliferation: natural history and progression of visual loss. Retina. 2009;29(6):732–9.CrossRefPubMed
4.
go back to reference Bressler NM. Retinal anastomosis to choroidal neovascularization: a bum rap for a difficult disease. Arch Ophthalmol. 2005;123(12):1741–3.CrossRefPubMed Bressler NM. Retinal anastomosis to choroidal neovascularization: a bum rap for a difficult disease. Arch Ophthalmol. 2005;123(12):1741–3.CrossRefPubMed
5.
go back to reference Bottoni F, Massacesi A, Cigada M, Viola F, Musicco I, Staurenghi G. Treatment of retinal angiomatous proliferation in age-related macular degeneration: a series of 104 cases of retinal angiomatous proliferation. Arch Ophthalmol. 2005;123(12):1644–50.CrossRefPubMed Bottoni F, Massacesi A, Cigada M, Viola F, Musicco I, Staurenghi G. Treatment of retinal angiomatous proliferation in age-related macular degeneration: a series of 104 cases of retinal angiomatous proliferation. Arch Ophthalmol. 2005;123(12):1644–50.CrossRefPubMed
6.
go back to reference Kuroiwa S, Arai J, Gaun S, Iida T, Yoshimura N. Rapidly progressive scar formation after transpupillary thermotherapy in retinal angiomatous proliferation. Retina. 2003;23(3):417–20.CrossRefPubMed Kuroiwa S, Arai J, Gaun S, Iida T, Yoshimura N. Rapidly progressive scar formation after transpupillary thermotherapy in retinal angiomatous proliferation. Retina. 2003;23(3):417–20.CrossRefPubMed
7.
go back to reference Sakimoto S, Gomi F, Sakaguchi H, Tano Y. Recurrent retinal angiomatous proliferation after surgical ablation. Am J Ophthalmol. 2005;139(5):917–8.CrossRefPubMed Sakimoto S, Gomi F, Sakaguchi H, Tano Y. Recurrent retinal angiomatous proliferation after surgical ablation. Am J Ophthalmol. 2005;139(5):917–8.CrossRefPubMed
8.
go back to reference Boscia F, Furino C, Sborgia L, Reibaldi M, Sborgia C. Photodynamic therapy for retinal angiomatous proliferations and pigment epithelium detachment. Am J Ophthalmol. 2004;138(6):1077–9.CrossRefPubMed Boscia F, Furino C, Sborgia L, Reibaldi M, Sborgia C. Photodynamic therapy for retinal angiomatous proliferations and pigment epithelium detachment. Am J Ophthalmol. 2004;138(6):1077–9.CrossRefPubMed
9.
go back to reference Saito M, Iida T, Kano M. Combined intravitreal ranibizumab and photodynamic therapy for retinal angiomatous proliferation. Am J Ophthalmol. 2012;153(3):504–14. e501.CrossRefPubMed Saito M, Iida T, Kano M. Combined intravitreal ranibizumab and photodynamic therapy for retinal angiomatous proliferation. Am J Ophthalmol. 2012;153(3):504–14. e501.CrossRefPubMed
10.
go back to reference Rouvas AA, Papakostas TD, Vavvas D, Vergados I, Moschos MM, Kotsolis A, et al. Intravitreal ranibizumab, intravitreal ranibizumab with PDT, and intravitreal triamcinolone with PDT for the treatment of retinal angiomatous proliferation: a prospective study. Retina. 2009;29(4):536–44.CrossRefPubMed Rouvas AA, Papakostas TD, Vavvas D, Vergados I, Moschos MM, Kotsolis A, et al. Intravitreal ranibizumab, intravitreal ranibizumab with PDT, and intravitreal triamcinolone with PDT for the treatment of retinal angiomatous proliferation: a prospective study. Retina. 2009;29(4):536–44.CrossRefPubMed
11.
go back to reference Kliffen M, Sharma HS, Mooy CM, Kerkvliet S, De Jong PT. Increased expression of angiogenic growth factors in age-related maculopathy. Br J Ophthalmol. 1997;81(2):154–62.CrossRefPubMedPubMedCentral Kliffen M, Sharma HS, Mooy CM, Kerkvliet S, De Jong PT. Increased expression of angiogenic growth factors in age-related maculopathy. Br J Ophthalmol. 1997;81(2):154–62.CrossRefPubMedPubMedCentral
12.
go back to reference Oh H, Takagi H, Takagi C, Suzuma K, Otani A, Ishida K, et al. The potential angiogenic role of macrophages in the formation of choroidal neovascular membranes. Invest Ophthalmol Vis Sci. 1999;40(9):1891–8.PubMed Oh H, Takagi H, Takagi C, Suzuma K, Otani A, Ishida K, et al. The potential angiogenic role of macrophages in the formation of choroidal neovascular membranes. Invest Ophthalmol Vis Sci. 1999;40(9):1891–8.PubMed
13.
go back to reference Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419–31.CrossRefPubMed Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419–31.CrossRefPubMed
14.
go back to reference Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1432–44.CrossRefPubMed Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1432–44.CrossRefPubMed
15.
go back to reference Meyerle CB, Freund KB, Iturralde D, Spaide RF, Sorenson JA, Slakter JS, et al. Intravitreal bevacizumab (Avastin) for retinal angiomatous proliferation. Retina. 2007;27(4):451–7.CrossRefPubMed Meyerle CB, Freund KB, Iturralde D, Spaide RF, Sorenson JA, Slakter JS, et al. Intravitreal bevacizumab (Avastin) for retinal angiomatous proliferation. Retina. 2007;27(4):451–7.CrossRefPubMed
16.
go back to reference Shimada H, Kawamura A, Mori R, Yuzawa M. Clinicopathological findings of retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol. 2007;245(2):295–300.CrossRefPubMed Shimada H, Kawamura A, Mori R, Yuzawa M. Clinicopathological findings of retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol. 2007;245(2):295–300.CrossRefPubMed
17.
go back to reference Rouvas A, Petrou P, Vergados I, Pechtasides D, Liarakos V, Mitsopoulou M, et al. Intravitreal ranibizumab (Lucentis) for treatment of central retinal vein occlusion: a prospective study. Graefes Arch Clin Exp Ophthalmol. 2009;247(12):1609–16.CrossRefPubMed Rouvas A, Petrou P, Vergados I, Pechtasides D, Liarakos V, Mitsopoulou M, et al. Intravitreal ranibizumab (Lucentis) for treatment of central retinal vein occlusion: a prospective study. Graefes Arch Clin Exp Ophthalmol. 2009;247(12):1609–16.CrossRefPubMed
18.
go back to reference Montero JA, Fernandez MI, Gomez-Ulla F, Ruiz-Moreno JM. Efficacy of intravitreal bevacizumab to treat retinal angiomatous proliferation stage II and III. Eur J Ophthalmol. 2009;19(3):448–51.PubMed Montero JA, Fernandez MI, Gomez-Ulla F, Ruiz-Moreno JM. Efficacy of intravitreal bevacizumab to treat retinal angiomatous proliferation stage II and III. Eur J Ophthalmol. 2009;19(3):448–51.PubMed
19.
go back to reference Kramann CA, Schopfer K, Lorenz K, Zwiener I, Stoffelns BM, Pfeiffer N. Intravitreal ranibizumab treatment of retinal angiomatous proliferation. Acta Ophthalmol. 2012;90(5):487–91.CrossRefPubMed Kramann CA, Schopfer K, Lorenz K, Zwiener I, Stoffelns BM, Pfeiffer N. Intravitreal ranibizumab treatment of retinal angiomatous proliferation. Acta Ophthalmol. 2012;90(5):487–91.CrossRefPubMed
20.
go back to reference Atmani K, Voigt M, Le Tien V, Querques G, Coscas G, Soubrane G, et al. Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration. Eye (Lond). 2010;24(7):1193–8.CrossRef Atmani K, Voigt M, Le Tien V, Querques G, Coscas G, Soubrane G, et al. Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration. Eye (Lond). 2010;24(7):1193–8.CrossRef
21.
go back to reference Nakano S, Honda S, Oh H, Kita M, Negi A. Effect of photodynamic therapy (PDT), posterior subtenon injection of triamcinolone acetonide with PDT, and intravitreal injection of ranibizumab with PDT for retinal angiomatous proliferation. Clin Ophthalmol. 2012;6:277–82.PubMedPubMedCentral Nakano S, Honda S, Oh H, Kita M, Negi A. Effect of photodynamic therapy (PDT), posterior subtenon injection of triamcinolone acetonide with PDT, and intravitreal injection of ranibizumab with PDT for retinal angiomatous proliferation. Clin Ophthalmol. 2012;6:277–82.PubMedPubMedCentral
22.
go back to reference Sahu AK, Narayanan R. Intravitreal ranibizumab, intravitreal ranibizumab with photodynamic therapy (PDT), and intravitreal triamcinolone with PDT for the treatment of retinal angiomatous proliferation. Retina. 2010;30(6):981. author reply 981.CrossRefPubMed Sahu AK, Narayanan R. Intravitreal ranibizumab, intravitreal ranibizumab with photodynamic therapy (PDT), and intravitreal triamcinolone with PDT for the treatment of retinal angiomatous proliferation. Retina. 2010;30(6):981. author reply 981.CrossRefPubMed
23.
go back to reference Rouvas AA, Papakostas TD, Ladas ID, Vergados I. Enlargement of the hypofluorescent post photodynamic therapy treatment spot after a combination of photodynamic therapy with an intravitreal injection of bevacizumab for retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol. 2008;246(2):315–8.CrossRefPubMed Rouvas AA, Papakostas TD, Ladas ID, Vergados I. Enlargement of the hypofluorescent post photodynamic therapy treatment spot after a combination of photodynamic therapy with an intravitreal injection of bevacizumab for retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol. 2008;246(2):315–8.CrossRefPubMed
24.
go back to reference Rouvas AA, Chatziralli IP, Theodossiadis PG, Moschos MM, Kotsolis AI, Ladas ID. Long-term results of intravitreal ranibizumab, intravitreal ranibizumab with photodynamic therapy, and intravitreal triamcinolone with photodynamic therapy for the treatment of retinal angiomatous proliferation. Retina. 2012;32(6):1181–9.CrossRefPubMed Rouvas AA, Chatziralli IP, Theodossiadis PG, Moschos MM, Kotsolis AI, Ladas ID. Long-term results of intravitreal ranibizumab, intravitreal ranibizumab with photodynamic therapy, and intravitreal triamcinolone with photodynamic therapy for the treatment of retinal angiomatous proliferation. Retina. 2012;32(6):1181–9.CrossRefPubMed
25.
go back to reference McBain VA, Kumari R, Townend J, Lois N. Geographic atrophy in retinal angiomatous proliferation. Retina. 2011;31(6):1043–52.CrossRefPubMed McBain VA, Kumari R, Townend J, Lois N. Geographic atrophy in retinal angiomatous proliferation. Retina. 2011;31(6):1043–52.CrossRefPubMed
26.
go back to reference Lalwani GA, Rosenfeld PJ, Fung AE, Dubovy SR, Michels S, Feuer W, et al. A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration: year 2 of the PrONTO Study. Am J Ophthalmol. 2009;148(1):43–58. e41.CrossRefPubMed Lalwani GA, Rosenfeld PJ, Fung AE, Dubovy SR, Michels S, Feuer W, et al. A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration: year 2 of the PrONTO Study. Am J Ophthalmol. 2009;148(1):43–58. e41.CrossRefPubMed
27.
go back to reference Fung AE, Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, et al. An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol. 2007;143(4):566–83.CrossRefPubMed Fung AE, Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, et al. An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol. 2007;143(4):566–83.CrossRefPubMed
28.
go back to reference Konstantinidis L, Mameletzi E, Mantel I, Pournaras JA, Zografos L, Ambresin A. Intravitreal ranibizumab (Lucentis) in the treatment of retinal angiomatous proliferation (RAP). Graefes Arch Clin Exp Ophthalmol. 2009;247(9):1165–71.CrossRefPubMed Konstantinidis L, Mameletzi E, Mantel I, Pournaras JA, Zografos L, Ambresin A. Intravitreal ranibizumab (Lucentis) in the treatment of retinal angiomatous proliferation (RAP). Graefes Arch Clin Exp Ophthalmol. 2009;247(9):1165–71.CrossRefPubMed
29.
go back to reference Maier M, Perz C, Bockmaier J, Feucht N, Lohmann CP. Therapy of stage III retinal angiomatous proliferation : Intravitreal ranibizumab injections. Ophthalmologe. 2012;110(12):1171–8.CrossRef Maier M, Perz C, Bockmaier J, Feucht N, Lohmann CP. Therapy of stage III retinal angiomatous proliferation : Intravitreal ranibizumab injections. Ophthalmologe. 2012;110(12):1171–8.CrossRef
30.
go back to reference Parodi MB, Iacono P, Menchini F, Sheth S, Polini G, Pittino R, et al. Intravitreal bevacizumab versus ranibizumab for the treatment of retinal angiomatous proliferation. Acta Ophthalmol. 2011. Parodi MB, Iacono P, Menchini F, Sheth S, Polini G, Pittino R, et al. Intravitreal bevacizumab versus ranibizumab for the treatment of retinal angiomatous proliferation. Acta Ophthalmol. 2011.
31.
go back to reference Kaiser PK, Brown DM, Zhang K, Hudson HL, Holz FG, Shapiro H, et al. Ranibizumab for predominantly classic neovascular age-related macular degeneration: subgroup analysis of first-year ANCHOR results. Am J Ophthalmol. 2007;144(6):850–7.CrossRefPubMed Kaiser PK, Brown DM, Zhang K, Hudson HL, Holz FG, Shapiro H, et al. Ranibizumab for predominantly classic neovascular age-related macular degeneration: subgroup analysis of first-year ANCHOR results. Am J Ophthalmol. 2007;144(6):850–7.CrossRefPubMed
32.
go back to reference Lee MY, Kim KS, Lee WK. Combination therapy of ranibizumab and photodynamic therapy for retinal angiomatous proliferation with serous pigment epithelial detachment in Korean patients: twelve-month results. Retina. 2011;31(1):65–73.CrossRefPubMed Lee MY, Kim KS, Lee WK. Combination therapy of ranibizumab and photodynamic therapy for retinal angiomatous proliferation with serous pigment epithelial detachment in Korean patients: twelve-month results. Retina. 2011;31(1):65–73.CrossRefPubMed
33.
go back to reference Rouvas AA, Papakostas TD, Ntouraki A, Douvali M, Vergados I, Ladas ID. Angiographic and OCT features of retinal angiomatous proliferation. Eye (Lond). 2010;24(11):1633–42. quiz 1643.CrossRef Rouvas AA, Papakostas TD, Ntouraki A, Douvali M, Vergados I, Ladas ID. Angiographic and OCT features of retinal angiomatous proliferation. Eye (Lond). 2010;24(11):1633–42. quiz 1643.CrossRef
Metadata
Title
One year results of intravitreal ranibizumab monotherapy for retinal angiomatous proliferation: a comparative analysis based on disease stages
Authors
Young Gun Park
Young-Jung Roh
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2015
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-015-0172-2

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