title: Long-term results of intravitreal ranibizumab, intravitreal ranibizumab with photodynamic therapy, and intravitreal triamcinolone with photodynamic therapy for the treatment of retinal angiomatous proliferation.
abstract: OBJECTIVE
  To compare intravitreal ranibizumab, intravitreal ranibizumab plus photodynamic therapy (PDT), and intravitreal triamcinolone plus PDT in retinal angiomatous proliferation, presenting the results of a 3-year follow-up.
  
  
  METHODS
  Thirty-seven eyes of 37 patients with retinal angiomatous proliferation were randomized to 1 of the 3 groups. Group 1 (n = 13) received 3 monthly injections of 0.5 mg ranibizumab, Group 2 (n = 13) received 1 session of PDT and 3 monthly injections of ranibizumab, and Group 3 (n = 11) received 1 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/intraretinal fluid.
  
  
  RESULTS
  Twelve patients in Groups 1 and 2 and 9 patients in Group 3 completed the 3-year follow-up. A total of 58% of patients in Group 1, 50% in Group 2, and 88.9% in Group 3 had the same or better visual acuity at the end of the follow-up (P = 0.081). Patients in Group 3 exhibited considerable improvement in visual acuity (P = 0.032) and statistically significant decrease in central retinal thickness (P < 0.0001) than the 2 other groups at the end of the follow-up. Also, the patients in Group 3 received on average the lowest number of injections (P < 0.0001). Of note, geographic atrophy mainly at the place of previous retinal angiomatous proliferation lesion was detected in 0% in Group 1, 25% in Group 2, and 55.6% in Group 3 (P = 0.203), while 33.3% of patients in Group 1 developed retinal scar.
  
  
  CONCLUSIONS
  Treatment with ranibizumab or ranibizumab plus PDT resulted in stabilization of the disease, while treatment with IVT plus PDT achieved better results in terms of functional and anatomical features compared with the other groups.
authors.affiliation: 2nd Department of Ophthalmology, ATTIKON Hospital, University of Athens, Medical School of Athens, Athens, Greece.
authors.forename: Alexandros A
authors.initials: AA
authors.lastname: Rouvas
authors.forename: Irini P
authors.initials: IP
authors.lastname: Chatziralli
authors.forename: Panagiotis G
authors.initials: PG
authors.lastname: Theodossiadis
authors.forename: Marilita M
authors.initials: MM
authors.lastname: Moschos
authors.forename: Athanasios I
authors.initials: AI
authors.lastname: Kotsolis
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Ladas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D010778:Photochemotherapy / Q000379:methods*; D000069579:Ranibizumab; D015861:Retinal Neovascularization / Q000188:drug therapy*; D014221:Triamcinolone / Q000008:administration & dosage*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D014221:Triamcinolone; D000069579:Ranibizumab