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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

Gharbiya, Magda MD, FEBO*; Parisi, Francesco MD*; Cruciani, Filippo MD*; Bozzoni-Pantaleoni, Francesco MD; Pranno, Federica MD*; Abdolrahimzadeh, Solmaz MD*

doi: 10.1097/IAE.0b013e3182979e62
Original Study

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.

Stable or improved visual acuity was obtained in 95% of eyes at 2 years and 100% of eyes at 3 years for retinal angiomatous proliferation lesions treated with anti–vascular endothelial growth factor. Complete occlusion was obtained in 71% and 69% of eyes at 2 years and 3 years, respectively. Pigment epithelial detachment at baseline correlated negatively with best-corrected visual acuity outcome and was significantly associated with the need for retreatment.

*Department of Ophthalmology, Sapienza University, Policlinico Umberto I, Rome, Italy; and

Department of Ophthalmology, San Filippo Neri Hospital, Rome, Italy.

Reprint requests: Magda Gharbiya, MD, FEBO, Department of Ophthalmology, Sapienza University, Policlinico Umberto I, 155, Viale del Policlinico, Rome 00161, Italy; e-mail: magda.gharbiya@tiscali.it

None of the authors have any financial/conflicting interests to disclose.

This study was performed at the Eye Clinic of the Umberto I Hospital of the Sapienza University of Rome, Italy. The study protocol was prospectively approved by the Institutional Review Board of the Sapienza University of Rome. All participants signed an informed consent filled in accordance with the Italian laws regarding privacy. The study adhered to the tenets of the Declaration of Helsinki.

© 2014 by Ophthalmic Communications Society, Inc.