title: Long-Term Management of RAP Lesions in Clinical Practice: Treatment Efficacy and Predictors of Functional Improvement.
abstract: OBJECTIVE
  To evaluate the long-term efficacy of ranibizumab in the treatment of retinal angiomatous proliferation (RAP) and to identify predictors of functional outcome.
  
  
  METHODS
  Retrospective case series comprised 79 eyes of 68 consecutive patients with RAP followed up ≥36 months. Primary end-points were best-corrected visual acuity (BCVA) and central macular thickness (CMT) variation at 36 months and at the last visit.
  
  
  RESULTS
  Mean follow-up time was 59.8 ± 16.0 months. All eyes were treated with pro re nata ranibizumab, with (n = 33) or without (n = 46) photodynamic therapy (PDT). Stabilization or improvement in BCVA was observed in 50.6% of the patients at 36 months, and in 40.5% at the end of the follow-up, where 20.3% preserved reading vision. A significant decrease in CMT was observed at 36 months (p < 0.001), but not at the end of the follow-up. Geographic atrophy (GA) was present in 59.5% of the eyes at the final visit. Baseline subretinal fluid was associated with better visual outcomes (p = 0.001). Results of combination treatment with intravitreal ranibizumab and PDT did not significantly differ from ranibizumab monotherapy.
  
  
  CONCLUSIONS
  Modest functional outcomes can be expected from the long-term treatment of RAP lesions in clinical practice, most likely due to the advent of GA. Baseline subretinal fluid positively correlated with final BCVA.
authors.affiliation: Department of Ophthalmology, Centro Hospitalar e Universitx00E1;rio de Coimbra (CHUC), Coimbra, Portugal.
authors.forename: Marco Frederico
authors.initials: MF
authors.lastname: Marques
authors.forename: João Pedro
authors.initials: JP
authors.lastname: Marques
authors.forename: João Quadrado
authors.initials: JQ
authors.lastname: Gil
authors.forename: José
authors.initials: J
authors.lastname: Costa
authors.forename: Elisabete
authors.initials: E
authors.lastname: Almeida
authors.forename: Maria da Luz
authors.initials: Mda L
authors.lastname: Cachulo
authors.forename: Isabel
authors.initials: I
authors.lastname: Pires
authors.forename: João
authors.initials: J
authors.lastname: Figueira
authors.forename: Rufino
authors.initials: R
authors.lastname: Silva
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D015861:Retinal Neovascularization / Q000188:drug therapy*; D012189:Retrospective Studies; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab