title: Ranibizumab in retinal angiomatous proliferation (RAP): influence of RAP stage on visual outcome.
abstract: OBJECTIVE
  To evaluate the influence of retinal angiomatous proliferation (RAP) stage on visual and anatomic outcome after ranibizumab (Lucentis®).
  
  
  METHODS
  This was a prospective study on consecutively diagnosed RAP eyes at the Hospital Clínico San Carlos, Madrid. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) are performed monthly. Indocyanine green angiography (ICG) and fluorescein angiography (FA) are performed at baseline and every 3 months thereafter. A starting dose of a monthly ranibizumab injection in the first 3 months is followed by retreatment in case of intraretinal edema, subretinal fluid, or pigment epithelium detachment (PED) in OCT, increased leakage in FA, or a hot spot in ICG.
  
  
  RESULTS
  A total of 53 eyes from 49 patients were included. The mean change in BCVA at 12 months was +7.3, +0.83, and -2.1 letters in stages IIA (21 cases), II B (18 cases), and III (14 cases), respectively. After adjusting the change in BCVA according to baseline BCVA, ß coefficient was -6.012 letters (p=0.025) in stage IIB and -9.762 letters (p=0.003) in stage III vs stage IIA. Four cases had a retinal pigment epithelium tear after injection of ranibizumab.
  
  
  CONCLUSIONS
  Patients in stage II without PED have a better visual and anatomic evolution than patients in stage II with PED and stage III.
authors.affiliation: Ophthalmology Department, Hospital Clinico San Carlos, Madrid, Spain. rechejuan@yahoo.es
authors.forename: Juan
authors.initials: J
authors.lastname: Reche-Frutos
authors.forename: Cristina
authors.initials: C
authors.lastname: Calvo-Gonzalez
authors.forename: Silvia
authors.initials: S
authors.lastname: Pérez-Trigo
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernandez-Perez
authors.forename: Juan
authors.initials: J
authors.lastname: Donate-Lopez
authors.forename: Julian
authors.initials: J
authors.lastname: Garcia-Feijoo
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D000069579:Ranibizumab; D015861:Retinal Neovascularization / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D019233:Retreatment; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007208:Indocyanine Green; D000069579:Ranibizumab