Klin Monbl Augenheilkd 2015; 232(4): 570-572
DOI: 10.1055/s-0034-1396332
Der interessante Fall
Georg Thieme Verlag KG Stuttgart · New York

Ranibizumab Treatment for Retinal Angiomatous Proliferation Lesions: A Case Report with Life-Long Expectancy (Seven Years) Follow-Up

Ranibizumab in der Behandlung retinaler angiomatöser Proliferations Läsionen: Eine Fallstudie mit langer Lebenserwartung (verfolgt über sieben Jahre)
G. Donati
1   Department of Ophthalmology, University Hospitals of Geneva, Geneva, Switzerland
2   Centre Ophtalmologique de Rive, Geneva, Switzerland
3   Centre Ophtalmologique de La Colline, Clinique La Colline, Geneva, Switzerland
,
C. J. Pournaras
2   Centre Ophtalmologique de Rive, Geneva, Switzerland
3   Centre Ophtalmologique de La Colline, Clinique La Colline, Geneva, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
22 April 2015 (online)

Background

Retinal angiomatous proliferation (RAP) is a distinct variant of neovascular age-related macular degeneration (AMD). Up to 15 % of the patients diagnosed with neovascular AMD show a typical presentation of RAP and these lesions are associated with poor prognosis [1]. Direct laser photocoagulation, transpupillary thermotherapy, surgical removal, and photodynamic therapy (PDT) with verteporfin (Visudyne®; Novartis Pharma AG, Basel, Switzerland) have all been used for the treatment of RAP in the past with unsatisfactory results. More recently, some studies have reported promising results with off-label use of the intravitreal anti-vascular endothelial growth factor drug bevacizumab (Avastin®; Genentech, South San Francisco, CA, USA) and very favourable results with the use of intravitreal ranibizumab (Lucentis®, Novartis Pharma AG, Basel, Switzerland, and Genentech Inc., South San Francisco, CA; [2], [3]). Outcome from preliminary studies suggest that, RAP, although classically considered as a distinctive subset of neovascular AMD, may respond to ranibizumab treatment in a manner similar to that of the other types of exudative AMD which have been explored in the pivotal MARINA and ANCHOR studies [4], [5]. To date, there are very limited data exploring the long-term clinical benefit of ranibizumab treatment in RAP lesions, with only few studies reporting good visual outcomes over an extended follow-up [6], [7]. Here, we present the case of a patient presenting with chronically active RAP lesion in her left eye treated with ranibizumab for 7 years.

 
  • References

  • 1 Yannuzzi LA, Freund KB, Takahashi BS et al. Review of retinal angiomatous proliferation or type 3 neovascularization. Retina 2008; 28: 375-384
  • 2 Parodi MB, Iacono P, Menchini F et al. Intravitreal bevacizumab versus ranibizumab for the treatment of retinal angiomatous proliferation. Acta Ophthalmol 2013; 91: 267-273
  • 3 Mones J, Biarnés M, Badal J. Bimonthly half-dose ranibizumab in large pigment epithelial detachment and retinal angiomatous proliferation with high risk of retinal pigment epithelium tear: a case report. Clin Ophthalmol 2013; 7: 1089-1092
  • 4 Brown DM, Kaiser PK, Michels M et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 2006; 355: 1432-1444
  • 5 Rosenfeld PJ, Brown DM, Heier JS et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 2006; 355: 1419-1431
  • 6 Rouvas AA, Chatziralli IP, Theodossiadis PG et al. Long-term results of intravitreal ranibizumab, intravitreal ranibizumab with photodynamic therapy, and intravitreal triamcinolone with photodynamic therapy for the treatment of retinal angiomatous proliferation. Retina 2012; 32: 1181-1189
  • 7 Inoue M, Arakawa A, Yamane S et al. Intravitreal injection of ranibizumab using a pro re nata regimen for age-related macular degeneration and vision-related quality of life. Clin Ophthalmol 2014; 8: 1711-1716
  • 8 Bandello F, Lafuma A, Berdeaux G. Public health impact of neovascular age-related macular degeneration treatments extrapolated from visual acuity. Invest Ophthalmol Vis Sci 2007; 48: 96-103
  • 9 Rofagha S, Bhisitkul RB, Boyer DS et al. Seven-year outcomes in ranibizumab-treated patients in ANCHOR, MARINA, and HORIZON: a multicenter cohort study (SEVEN-UP). Ophthalmology 2013; 120: 2292-2299