Abstract

P 270

Visual and morphological outcomes of Bevacizumab (Avastin®) and Ranibizumab (Lucentis®) treatment for Retinal Angiomatous Proliferation

Katerina Hufendiek, Georgios Panagakis, Horst Helbig, Maria Andreea Gamulescu
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Regensburg

Objective
Retinal angiomatous proliferation (RAP) is a variant of exudative age-related macular degeneration (ARMD) with particularly bad prognosis. It is characterized by the proliferation of retinal capillaries and extending process into the deep retina and subretinal space with development of retinal - choroidal anastomosis. The purpose of this work is to describe long-term functional and morphological outcome of patients treated with intravitreal bevacizumab and ranibizumab.
Methods
Retrospective case series of 18 eyes of 18 patients treated with bevacizumab and 19 eyes of 16 patients treated with ranibizumab. After informed consent, all patients received initially three intravitreal injections of bevacizumab (1.25mg/0.05ml) or ranibizumab (0.5mg/0.05ml) every 4 weeks. Follow-up ranged up to 6 months after the third injection. Complete ophthalmologic examination including best-corrected visual acuity (BCVA), optical coherence tomography (OCT), fluorescein angiography (FA), and in selected cases indocyanine green angiography (ICGA) was performed. Decimal BCVA was converted into logMAR (logarithm of the minimal angle of resolution) for statistical analysis. CMT (central macular thickness) in OCT was measured in µm. BCVA and CMT at baseline and each follow-up visit were compared using Student's t-test (P < 0.05 for 95% confidence level).
Results
Triple intravitreal injections resulted in improvement of BCVA in bevacizumab as well as in ranibizumab treated patients during the first three months and stabilisation thereafter (logMAR 0.82 before treatment and 0.59 at month 9, and logMAR 0.92 before treatment and 0.67 at month 9 respectively). In the bevacizumab group 5 eyes (26.3%) needed retreatment at months 5 or 6, while in the ranibizumab group 9 eyes (47.4%) needed retreatment at months 5 or 6. CMT in the bevacizumab group regressed slightly but did not reach statistical significane and was maintained over time. CMT in the ranibizumab group improved from 501 µm at baseline to 243 µm at month 6 and reached statistical significance (p=0.03).
Conclusions
Patients with RAP might benefit from intravitreal bevacizumab and ranibizumab treatments with stabilisation of BCVA over a longer period of time. Close follow-up should nevertheless be performed in this special subgroup because of high recurrence rate and the need for frequent re-treatments.

Copyright: 2009 Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.