J Maaß1, D Sandner2, E Matthé2. 1. Klinik und Poliklinik für Augenheilkunde, Medizinische Fakultät "Carl Gustav Carus", Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland. johanna.maass@uniklinikum-dresden.de. 2. Klinik und Poliklinik für Augenheilkunde, Medizinische Fakultät "Carl Gustav Carus", Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Abstract
BACKGROUND: Retinal angiomatous proliferations (RAP) are a subgroup of exsudative or "wet" age-related macular degeneration (wAMD) with devastating reduction of visual acuity in later stages. Intravitreal ranibizumab provides good therapy, but is considered to be less effective than in other choroidal neovascularizations (CNV). OBJECTIVE: We investigated the efficacy of ranibizumab in late-stage III RAP with retinochoroidal anastomosis compared to the outcome of other CNV lesions. MATERIALS AND METHODS: The data of all patients with wAMD treated with ranibizumab were retrospectively analyzed. Patients were divided into groups depending on the lesion type into RAP (identified and selected clinically, proven by fluorescein angiography) and CNV lesions (identified by fluorescein angiography only) named occult, minimally and predominantly classic groups. The best-corrected visual acuity (BCVA) was obtained before (at the timepoint "diagnosis"), during (1st, 2nd, and 3rd injection), and after upload ("1st control"). RESULTS: Before first injection, visual acuity decreased in all groups (0.73 to 0.78 logMAR for all CNV, 0.95 to 1.02 logMAR for RAP). During upload there was no further decline in visual acuity but no improvement as well up to the 1st control visit in the RAP group (1.02 to 1.03 logMAR), but a statistically significant increase in all other groups (0.78 to 0.67 logMAR). CONCLUSION: Treatment of late-stage III RAP with ranibizumab is effective. Stabiliziation of visual acuity can be achieved, but-in contrast to other forms of CNV lesions-no further improvement. Therefore, patients with this special form need to be identified and treated as early as possible.
BACKGROUND:Retinal angiomatous proliferations (RAP) are a subgroup of exsudative or "wet" age-related macular degeneration (wAMD) with devastating reduction of visual acuity in later stages. Intravitreal ranibizumab provides good therapy, but is considered to be less effective than in other choroidal neovascularizations (CNV). OBJECTIVE: We investigated the efficacy of ranibizumab in late-stage III RAP with retinochoroidal anastomosis compared to the outcome of other CNV lesions. MATERIALS AND METHODS: The data of all patients with wAMD treated with ranibizumab were retrospectively analyzed. Patients were divided into groups depending on the lesion type into RAP (identified and selected clinically, proven by fluorescein angiography) and CNV lesions (identified by fluorescein angiography only) named occult, minimally and predominantly classic groups. The best-corrected visual acuity (BCVA) was obtained before (at the timepoint "diagnosis"), during (1st, 2nd, and 3rd injection), and after upload ("1st control"). RESULTS: Before first injection, visual acuity decreased in all groups (0.73 to 0.78 logMAR for all CNV, 0.95 to 1.02 logMAR for RAP). During upload there was no further decline in visual acuity but no improvement as well up to the 1st control visit in the RAP group (1.02 to 1.03 logMAR), but a statistically significant increase in all other groups (0.78 to 0.67 logMAR). CONCLUSION: Treatment of late-stage III RAP with ranibizumab is effective. Stabiliziation of visual acuity can be achieved, but-in contrast to other forms of CNV lesions-no further improvement. Therefore, patients with this special form need to be identified and treated as early as possible.
Authors: Christina A Kramann; Kilian Schöpfer; Katrin Lorenz; Isabella Zwiener; Bernhard M Stoffelns; Norbert Pfeiffer Journal: Acta Ophthalmol Date: 2010-06-24 Impact factor: 3.761
Authors: J S Slakter; L A Yannuzzi; U Schneider; J A Sorenson; A Ciardella; D R Guyer; R F Spaide; K B Freund; D A Orlock Journal: Ophthalmology Date: 2000-04 Impact factor: 12.079
Authors: Alexandros A Rouvas; Thanos D Papakostas; Demetrios Vavvas; Ioannis Vergados; Marilita M Moschos; Athanasios Kotsolis; Ioannis D Ladas Journal: Retina Date: 2009-04 Impact factor: 4.256