Intravitreal injection of ranibizumab for retinal angiomatous proliferation_Chinese Journal of Ocular Fundus Diseases

Authors：

WangHuaihua , WangMin , XuNannan , 石德鹏 ,  徐海峰

Qingdao Eye Hospital, Shandong Eye Institute, Qingdao 266071, China;

Corresponding author：

徐海峰, Email: chxhf@126.com

Keywords：

Retinal diseases/drug therapy; Angiogenesis inhibitors/therapeutic use; Antibodies,monoclonal/therapeutic use

DOI：

10.3760/cma.j.issn.1005-1015.2014.05.009

Video：

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Objective To observe the efficacy of intravitreal injection of ranibizumab (IVR) for retinal angiomatous proliferation (RAP). Methods Eleven patients (14 eyes) with RAP were enrolled in this retrospective clinical study. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), and maximum retinal thickness (MRT) were detected by examination of visual acuity and optical coherence tomography (OCT). The average BCVA was 0.17±0.21, CRT was (382.71±219.07) μm, MRT was (746.36±268.29) μm. All eyes received 0.5 mg (0.05 ml) ranibizumab injection. Follow-up visits were performed monthly after injection. The mean follow-up time was (15.38±13.64) month. Injections were repeated if the eyes with retinal edema. The mean number of repetitive IVR was (3.7±1.0) times/eye (from 1 to 10 times). Changes in BCVA, CRT, MRT and complications were observed at the last follow up. Results At the last follow-up, the mean BCVA was 0.28±0.26 (from 0.01 to 1.0). Of 14 eyes, visual acuity improved in 11 eyes, not changed in 2 eyes and decreased in 1 eye. The difference of BCVA was significant between before and after the treatment (t=3.167,P=0.007). The mean CRT was (166.14±52.79) μm, which was less than that of pre-treatment values (t=3.737,P=0.002). The mean MRT was (360.43±102.19) μm, which was less than that of pre-treatment values (t=6.106,P=0.000). No ocular or systemic adverse effects occurred. Conclusion IVR is an efficient and safe treatment for RAP, with visual acuity improvement, decrease of CRT and MRT.

Citation： WangHuaihua, WangMin, XuNannan. Intravitreal injection of ranibizumab for retinal angiomatous proliferation. Chinese Journal of Ocular Fundus Diseases, 2014, 30(5): 466-469. doi: 10.3760/cma.j.issn.1005-1015.2014.05.009 Copy

1.	Yannuzzi LA, Negrao S, Iida T, et al. Retinal angiomatous proliferation in age-related macular degeneration[J]. Retina,2001,21:416-434.
2.	Bottoni F, Massacesi A, Cigada M,et al. Treatment of retinal angiomatous proliferation in age-related macular degeneration:a series of 104 cases of retinal angiomatous proliferation[J]. Arch Ophthalmol,2005,123:1644-1650.
3.	Hartnett ME, Weiter JJ, Staurenghi G,et al. Deep retinal vascular anomalous complexes in advanced age-related macular degeneration[J].Ophthalmology,1996,103:2042-2053.
4.	Bressler NM. Retinal anastomosis to choroidal neovascularization:a bum rap for a difficult disease[J].Arch Ophthalmol,2005,123:1741-1743.
5.	Johnson TM, Glaser BM. Focal laser ablation of retinal angiomatous proliferation[J]. Retina, 2006,26:765-772.
6.	Boscia F, Furino C, Sborgia L, et al. Photodynamic therapy for retinal angiomatous proliferations and pigment epithelium detachment[J]. Am J Ophthalmol, 2004, 138:1077-1079.
7.	Boscia F, Parodi MB, Furino C,et al. Photodynamic therapy with verteporfin for retinal angiomatous proliferation[J]. Graefe's Arch Clin Exp Ophthalmol,2006,244:1224-1232.
8.	Sakimoto S, Gomi F, Sakaguchi H,et al. Recurrent retinal angiomatous proliferation after surgical ablation[J].Am J Ophthalmol,2005,139:917-918.
9.	Shiragami C, Iida T, Nagayama D,et al. Recurrence after surgical ablation for retinal angiomatous proliferation[J].Retina,2007,27:198-203.
10.	曾繁星,徐海峰,孙晓蕾,等.光动力疗法联合玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab治疗视网膜血管瘤样增生的疗效观察[J]. 中华眼底病杂志, 2011, 27:582-584.
11.	Rouvas AA, Papakostas TD, Vavvas D, et al. Intravitreal ranibizumab, intravitreal ranibizumab with PDT, and intravitreal triamcinolone with PDT for the treatment of retinal angiomatous proliferation:a prospective study[J].Retina, 2009,29:536-544.
12.	Monson DM, Smith JR, Klein ML, et a1. Clinicopathologic correlation of retinal angiomatous proliferation[J].Arch Ophthalmol,2008,126:1664-1668.
13.	Shimada H, Kawamura A, Mori R, et al. Clinicopathological findings of retinal angiomatous proliferation[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245:295-300.
14.	Viola F, Manelli C, Villani E, et al. Sequential combined treatment with intravitreal bevacizumab and photodynamic therapy for retinal angiomatous proliferation[J]. Eye (Lond), 2010, 24:1344-1351.
15.	Reche-Frutos J, Calvo-Gonzalez C, Pérez-Trigo S, et al. Ranibizumab in retinal angiomatous proliferation (RAP):influence of RAP stage on visual outcome[J]. Eur J Ophthalmol, 2011,21:783-738.
16.	Kramann CA,SchÖpfer K,Lorenz K,et al.Intravitreal ranibizumab treatment of retinal angiomatous proliferation[J].Acta Ophthalmol, 2012, 90:487-491.
17.	Gross NE, Aizman A, Brucker A, et al. Nature and risk of neovascularization in the fellow eye of patients with unilateral retinal angiomatous proliferation[J]. Retina,2005,25:713-718.

1. Yannuzzi LA, Negrao S, Iida T, et al. Retinal angiomatous proliferation in age-related macular degeneration[J]. Retina,2001,21:416-434.
2. Bottoni F, Massacesi A, Cigada M,et al. Treatment of retinal angiomatous proliferation in age-related macular degeneration:a series of 104 cases of retinal angiomatous proliferation[J]. Arch Ophthalmol,2005,123:1644-1650.
3. Hartnett ME, Weiter JJ, Staurenghi G,et al. Deep retinal vascular anomalous complexes in advanced age-related macular degeneration[J].Ophthalmology,1996,103:2042-2053.
4. Bressler NM. Retinal anastomosis to choroidal neovascularization:a bum rap for a difficult disease[J].Arch Ophthalmol,2005,123:1741-1743.
5. Johnson TM, Glaser BM. Focal laser ablation of retinal angiomatous proliferation[J]. Retina, 2006,26:765-772.
6. Boscia F, Furino C, Sborgia L, et al. Photodynamic therapy for retinal angiomatous proliferations and pigment epithelium detachment[J]. Am J Ophthalmol, 2004, 138:1077-1079.
7. Boscia F, Parodi MB, Furino C,et al. Photodynamic therapy with verteporfin for retinal angiomatous proliferation[J]. Graefe's Arch Clin Exp Ophthalmol,2006,244:1224-1232.
8. Sakimoto S, Gomi F, Sakaguchi H,et al. Recurrent retinal angiomatous proliferation after surgical ablation[J].Am J Ophthalmol,2005,139:917-918.
9. Shiragami C, Iida T, Nagayama D,et al. Recurrence after surgical ablation for retinal angiomatous proliferation[J].Retina,2007,27:198-203.
10. 曾繁星,徐海峰,孙晓蕾,等.光动力疗法联合玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab治疗视网膜血管瘤样增生的疗效观察[J]. 中华眼底病杂志, 2011, 27:582-584.
11. Rouvas AA, Papakostas TD, Vavvas D, et al. Intravitreal ranibizumab, intravitreal ranibizumab with PDT, and intravitreal triamcinolone with PDT for the treatment of retinal angiomatous proliferation:a prospective study[J].Retina, 2009,29:536-544.
12. Monson DM, Smith JR, Klein ML, et a1. Clinicopathologic correlation of retinal angiomatous proliferation[J].Arch Ophthalmol,2008,126:1664-1668.
13. Shimada H, Kawamura A, Mori R, et al. Clinicopathological findings of retinal angiomatous proliferation[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245:295-300.
14. Viola F, Manelli C, Villani E, et al. Sequential combined treatment with intravitreal bevacizumab and photodynamic therapy for retinal angiomatous proliferation[J]. Eye (Lond), 2010, 24:1344-1351.
15. Reche-Frutos J, Calvo-Gonzalez C, Pérez-Trigo S, et al. Ranibizumab in retinal angiomatous proliferation (RAP):influence of RAP stage on visual outcome[J]. Eur J Ophthalmol, 2011,21:783-738.
16. Kramann CA,SchÖpfer K,Lorenz K,et al.Intravitreal ranibizumab treatment of retinal angiomatous proliferation[J].Acta Ophthalmol, 2012, 90:487-491.
17. Gross NE, Aizman A, Brucker A, et al. Nature and risk of neovascularization in the fellow eye of patients with unilateral retinal angiomatous proliferation[J]. Retina,2005,25:713-718.

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