Purpose:

To evaluate the 12 months functional outcome and morphological changes according stages after 3 monthly intravitreal ranibizumab injections for the treatment of retinal angiomatous proliferation (RAP) in Korea.

Methods:

A retrospective chart review of 40 patients (41 eyes) with RAP was conducted. Patients received three initial monthly intravitreal injections (0.5 mg) of ranibizumab and monitored monthly for 12 months. Reinjection of ranibizumab after three initial monthly loading was administered on as-needed basis guided by optical coherence tomography (OCT), fluorescein angiography (FAG) and indocyanine green angiography (ICGA) as well as with doctor’s discretion. The main outcome measures were the change of mean best corrected Snellen visual acuity (BCVA) and central macular thickness (CMT) by OCT, and total number of injections received during the 12 months.

Results:

A total of 41 eyes from 40 patients with a mean age of 67.09 (SD 11.76) years were included. The mean change in BCVA at 12 months was -0.286, -0.165, and -0.151 (LogMAR) in stages I (8 cases), II (17 cases), and III (16 cases), respectively. Stages I, II, and III reduced CMT from baseline after initial treatment by a mean of 32.72 ±56.75, 57.45 ±56.48 and 148.37 ±98.59 µm, respectively. On the average, additional 0.25, 1.43, and 2.18 injections were given after initial three injections over the 12 months. During 12 months of follow-up after initial treatment, the mean number of treatments was significantly lower in stage I than in stage II and stage III over 12 months after initial treatment (P<0.001, P<0.001, and P=0.15 for stage I versus stage II, stage I versus stage III and stage II versus stage III, respectively). Only one case in stage III had a submacular hemorrhage after injection of ranibizumab.

Conclusions:

The 12-months follow-up outcomes in our series suggest that three consecutive loading dose of intravitreal ranibizumab is an effective treatment for RAP. Most of all, patients in stage I showed significantly lower recurrence than patients in stage II and stage III.