title: Visual and morphological outcomes of bevacizumab (Avastin®) versus ranibizumab (Lucentis®) treatment for retinal angiomatous proliferation.
abstract: Retinal angiomatous proliferation (RAP) is a variant of exudative age-related macular degeneration with particularly bad prognosis. The purpose of this work is to describe the long-term functional and morphological outcome of patients treated with intravitreal bevacizumab and ranibizumab. Retrospective case series of 16 eyes treated with bevacizumab and 19 eyes treated with ranibizumab. All patients received initially three intravitreal injections of bevacizumab (1.25 mg/0.05 ml) or ranibizumab (0.5 mg/0.05 ml) every 4 weeks. Follow-up ranged from 1 to 7 months after the third injection. Complete ophthalmologic examination including best-corrected visual acuity (VA), optical coherence tomography, fluorescein angiography, and in selected cases, indocyanine green angiography was performed. Triple intravitreal injections resulted in improvement of VA in bevacizumab-treated as well as in ranibizumab-treated patients; logarithm of the minimal angle of resolution (logMAR) 0.84 before treatment and 0.67 at month 9, and logMAR 0.75 before treatment and 0.59 at month 9, respectively. Central macular thickness (CMT) in the bevacizumab group improved from 363.67 ± 47.4 μm at baseline to 328 ± 49.77 μm at month 6 (p = 0.03) and 301 ± 129.69 at month 9 (p = 0.35). CMT in the ranibizumab group improved from 545.62 ± 167.39 μm at baseline to 395.88 ± 169.37 μm at month 6 and 411.83 ± 212.41 μm at month 9 (p = 0.03, p = 0.05, respectively). Patients with RAP might benefit from both intravitreal bevacizumab and ranibizumab treatments with stabilization of VA over a longer period of time. Close follow-up should nevertheless be performed in this special subgroup because of the high recurrence rate.
authors.affiliation: Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany. katerina.hufendiek@klinik.uni-regensburg.de
authors.forename: Katerina
authors.initials: K
authors.lastname: Hufendiek
authors.forename: Karsten
authors.initials: K
authors.lastname: Hufendiek
authors.forename: Georgios
authors.initials: G
authors.lastname: Panagakis
authors.forename: Horst
authors.initials: H
authors.lastname: Helbig
authors.forename: Maria-Andreea
authors.initials: MA
authors.lastname: Gamulescu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012160:Retina / Q000473:pathology*; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D019233:Retreatment; D012189:Retrospective Studies; 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; D000068258:Bevacizumab; D007208:Indocyanine Green; D000069579:Ranibizumab