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Long-Term Visual and Anatomic Outcomes Following Anti-VEGF Monotherapy for Retinal Angiomatous Proliferation
  1. Tarek S Hemeida1,
  2. Pearse A Keane1,
  3. Laurie Dustin2,
  4. Srinivas R Sadda1,
  5. Amani A Fawzi1,*
  1. 1 Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine of the USC, United States;
  2. 2 Department of Preventative Medicine, Keck School of Medicine of the USC, United States
  1. Correspondence to: Amani A Fawzi, Ophthalmology, Doheny Retina Institute, United States, 1450 San Pablo Street, LA, 90033, United States; afawzi{at}doheny.org

Abstract

Purpose: To study the long-term visual and anatomic outcomes of anti-vascular endothelial growth factor (VEGF) monotherapy for the treatment of patients with retinal angiomatous proliferation (RAP).

Methods: Retrospective review of patients who were diagnosed with AMD and RAP lesions, and who received anti-VEGF injections as the only mode of therapy.

Results: 20 eyes (15 patients; 9 women, 6 men) with RAP lesions treated by anti- VEGF were encountered. Mean patient age was 85.8 years (SD ± 4.54). Nine eyes were treated with intravitreal ranibizumab alone, 8 eyes with bevacizumab alone, and 3 eyes received both drugs. At the 1, 3 and 6 month follow-up the median VA had improved from baseline (20/72) to 20/52, (range: 20/25 to 20/400), 20/45 (range: 20/20 to 20/400), and 20/56 (range: 20/20 to 20/400), respectively, (P> 0.001, P= 0.001, and P= 0.05, respectively). At 24 month follow-up, the improvement of VA, defined as halving of the visual angle, occurred in 37.5% of the cases.

Conclusions: Anti-VEGF monotherapy represents a useful treatment option for RAP, with stable or improved visual acuity in 62.5% of patients at 2 years. Although 25% of eyes only required a single injection, in most cases (75%) repeated treatments were required, therefore long-term follow-up is recommended.

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