Intravitreal anti-vascular endothelial growth factor for retinal angiomatous proliferation in treatment-naive eyes: long-term functional and anatomical results using a modified PrONTO-style regimen

Retina. 2014 Feb;34(2):298-305. doi: 10.1097/IAE.0b013e3182979e62.

Abstract

Purpose: To evaluate long-term outcome of intravitreal anti-vascular endothelial growth factor monotherapy in retinal angiomatous proliferation.

Methods: Twenty-one treatment-naive eyes were included in this prospective, interventional case series. Treatment was three monthly injections of bevacizumab and/or ranibizumab with a modified PrONTO-style regimen. Best-corrected visual acuity (BCVA) was evaluated. The influence of baseline BCVA and pretreatment pigment epithelial detachment on BCVA outcome or retreatment were assessed by Pearson correlation analysis.

Results: Results were evaluated at 2 years and 3 years for 21 and 13 eyes, respectively. Mean baseline BCVA improved significantly from 44.5 (± 11.0) (20/32) to 51.1 (± 9.7) (20/24) and 50.8 (± 10.4) letters (20/24) at 2 and 3 years, respectively (P = 0.02 and P = 0.049). Pigment epithelial detachment correlated negatively with BCVA outcome (r = -0.65, P = 0.002 and r = -0.67, P = 0.01 at 2 years and 3 years, respectively) and was significantly associated with retreatment (r = 0.62, P = 0.003 and r = 0.87, P < 0.0001 at 2 years and 3 years, respectively). Complete occlusion of the lesion was obtained in 71% and 69% of eyes at 2 years and 3 years, respectively, with a mean of 9.4 injections at 3 years.

Conclusion: Intravitreal anti-vascular endothelial growth factor monotherapy was a valid option for retinal angiomatous proliferation. Stable or improved visual acuity was obtained in 95% and 100% of eyes at 2 years and 3 years, respectively.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Bevacizumab
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Prospective Studies
  • Ranibizumab
  • Retinal Neovascularization / drug therapy*
  • Retinal Neovascularization / physiopathology
  • Retinal Pigment Epithelium / pathology
  • Retreatment
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity / physiology
  • Wet Macular Degeneration / drug therapy*
  • Wet Macular Degeneration / physiopathology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Ranibizumab