Ranibizumab for retinal angiomatous proliferation in neovascular age-related macular degeneration.
BACKGROUND
To report the efficacy of intravitreal injection of ranibizumab (Lucentis) in the treatment of retinal angiomatous proliferation (RAP) in neovascular age-related macular degeneration (AMD).


METHODS
Case review of four consecutive patients who received 3 injections at monthly intervals of intravitreal ranibizumab injections for RAP. The serial changes in best-corrected visual acuity (BCVA), optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography (ICGA) are presented.


RESULTS
The baseline mean logMAR BCVA was 0.89 (Snellen equivalent of 20/155). After three injections of ranibizumab, all four patients had visual improvement and the mean logMAR BCVA improved to 0.59 (Snellen equivalent of 20/78). The mean visual improvement was 3.0 lines. All patients also had complete resolution of subretinal fluid after treatment, and the mean OCT central foveal thickness reduced from 438 microm at baseline to 169 microm at 3 months. Follow-up FA and ICGA at 3 months showed absence of leakage in three patients with minimal leakage in the remaining patient. One patient had recurrence of RAP at 8 months after commencement of treatment, and repeat ranibizumab injection resulted in resolution of the subretinal fluid and pigment epithelial detachment and visual improvement.


CONCLUSIONS
Intravitreal ranibizumab injections appeared to be an effective treatment for RAP, resulting in visual gain and reduction in macular thickness. Further long-term studies to evaluate the efficacy of intravitreal ranibizumab in RAP are warranted.
Lai
Timothy Y Y
TY
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Hong Kong, SAR, People's Republic of China. tyylai@cuhk.edu.hk
Chan
Wai-Man
WM
Liu
David T
DT
Lam
Dennis S
DS
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D000069579:Ranibizumab; D015861:Retinal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D012171:Retinal Vessels / Q000187:drug effects* / Q000473:pathology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab