Abstract

P 260

Short-term effects of Anti-VEGF therapy in patients with retinal angiomatous proliferations

Horvath C., Wolf S., Theoulakis P., Brinkmann C., Sarra G., Einbock W., Fleischhauer J., Wolf-Schnurrbusch U.
University Eye Clinic Bern, Inselspital, Bern, Switzerland

Objective: Retinal angiomatous proliferation (RAP) is an aggressive form of exudative age-related macular degeneration (ARMD). Response to laser photocoagulation or to photodynamic therapy (PDT) alone is often ineffective. The purpose of this study was to evaluate short term effects of anti-VEGF therapy with ranibizumab (Lucentis^®) and/or bevacizumab (Avastin^®) in patients with RAP.
Methods: In total the charts of 159 consecutive patients with exudative ARMD treated with anti-VEGF therapy (ranibizumab and/or bevacizumab) were reviewed. From these 14 patients (6m, 8f) aged 53-90 years (mean 75.3±9.2 years) were diagnosed with RAP. Four from these patients presented with bilateral RAP lesions. At baseline 4 eyes presented RAP stage I, 11 eyes stage II and 3 eyes stage III. The mean follow-up was 8 months (range 6 to 13 months). In total 18 eyes were treated with anti-VEGF therapy following a standardised protocol. Visual acuity was documented at every follow-up. Central retinal thickness was analysed before and after treatment using OCT III (Stratus, Carl Zeiss Meditec, Jena, Deutschland). Angiographic images were additionally analyzed concerning CNV size, total lesion size and CNV activity and the vascular changes of the RAP.
Results: Initial visual acuity (VA) ranged from 20/100 to 20/40. At the last follow-up VA ranged from 20/125 to 20/32. No severe loss of visual acuity was observed during the follow-up, although the VA gain from baseline tended to decrease with time. After treatment CNV size, activity and central retinal thickness were significantly reduced in all patients Mean central retinal thickness at baseline was 365±104 mm (range 180 to 633 mm), and was reduced to 214±48 mm (range 176 to 287 mm) at the last follow-up visit.
Conclusions: RAP was found in 11% of the patients with exudative ARMD treated with anti-VEGF therapy. This study has highlighted the potential benefit in the short term of stabilizing or even improving vision after anti-VEGF therapy with ranibizumab and bevacizumab.

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