Intravitreal ranibizumab, intravitreal ranibizumab with PDT, and intravitreal triamcinolone with PDT for the treatment of retinal angiomatous proliferation: a prospective study.
OBJECTIVE
To compare 1) intravitreal ranibizumab, 2) intravitreal ranibizumab plus photodynamic therapy (PDT), and 3) intravitreal triamcinolone plus PDT in retinal angiomatous proliferation.


METHODS
In this prospective study, 37 eyes of 37 patients with retinal angiomatous proliferation were randomly assigned in 1 of the 3 groups. The patients in Group 1 (n = 13) received 3 monthly injections of 0.5 mg of ranibizumab. The patients in Group 2 (n = 13) received one session of PDT and 3 monthly intravitreal injections of 0.5 mg ranibizumab and the patients in Group 3 (n = 11) received one session of PDT and 1 injection of 4 mg triamcinolone. Retreatment, with the same therapeutic scheme in each group, was considered in case of persistence or recurrence of subretinal fluid or intraretinal fluid.


RESULTS
All the patients completed at least 6 months of follow-up. A total of 61.53% patients in Group 1, 76.92% in Group 2, and all in Group 3 had the same or better visual acuity at the end of the follow-up (P = 0.0232). The mean central retinal thickness reduction in Group 1 was 32.23 mum (P = 0.548), in Group 2 20.31 mum (P = 0.042), and in Group 3 73.92 mum (P < 0.0001). Also, the patients in Group 3 received on average the lowest number of injections (P < 0.0001).


CONCLUSIONS
All groups resulted in stabilization of the disease, while a significant trend towards better visual acuity and anatomic restoration of the affected area was observed in the intravitreal triamcinolone & PDT group.
Rouvas
Alexandros A
AA
2nd Department of Ophthalmology, Medical School of Athens University, Athens, Greece.
Papakostas
Thanos D
TD
Vavvas
Demetrios
D
Vergados
Ioannis
I
Moschos
Marilita M
MM
Kotsolis
Athanasios
A
Ladas
Ioannis D
ID
D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007267:Injections; D008297:Male; D010778:Photochemotherapy / Q000009:adverse effects; D000069579:Ranibizumab; D012160:Retina / Q000187:drug effects / Q000473:pathology; D019572:Retinal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage* / Q000009:adverse effects; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D014221:Triamcinolone; D000069579:Ranibizumab