title: Retinal angiomatous proliferation responds safely to a double dose (1.0 mg) of ranibizumab.
abstract: A 77-year-old man presented with sudden foggy central vision in the right eye. The visual acuity (VA) was 6/60 (R) and 6/6 (L). Funduscopy revealed superficial macular haemorrhage in the right eye. Using fluorescein angiography and indocyanine green angiography, retinal angiomatous proliferation was confirmed. Two intra-vitreal injections of bevacizumab were given but the VA did not improve. Following this, he received an intra-vitreal injection of ranibizumab. Regression of the retinal angiomatous proliferation was observed and the VA of the right eye returned to 6/10. Simultaneously, his left eye suffered from sudden visual loss and retinal angiomatous proliferation was diagnosed. Three intra-vitreal injections of ranibizumab were given. Regression of the retinal angiomatous proliferation was observed and the VA of the left eye was stabilised. Another 80-year-old man complained of sudden distorted vision in his left eye. Funduscopy and optical coherence tomography (OCT) revealed superficial macular haemorrhage and retinal pigment epithelial detachment (RPED). The VA was 6/12 and retinal angiomatous proliferation was diagnosed. He received an intra-vitreous injection of bevacizumab followed by photodynamic therapy (PDT). The RPED was resolved; however, the VA dropped to 2/60. Optical coherent tomography, fluorescein angiography and indocyanine green angiography were used to indentify retinal angiomatous proliferation. Intra-vitreal injection(s) of a double dose (1 mg) of ranibizumab is a worthwhile treatment, as it can stabilise and even improve the VA without significant side effects.
authors: Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan, Republic of China.
authors: Tsui-Kang
authors: TK
authors: Hsu
authors: Jorn-Hon
authors: JH
authors: Liu
authors: Jianqin
authors: J
authors: Lei
authors: Hsiao-Ming
authors: HM
authors: Chao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D000069579:Ranibizumab; D012160:Retina / Q000473:pathology*; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab