Long-term visual outcome and prognostic factors of Intravitreal anti-vascular endothelial growth factor treatment for retinal angiomatous proliferation

Abstract

Purpose: To evaluate the long-term visual outcomes and investigate the prognostic factors of anti-vascular endothelial growth factor (VEGF) therapy for retinal angiomatous proliferation (RAP).

Methods: Thirty-eight treatment-naïve RAP eyes (38 patients) that received intravitreal anti-VEGF (ranibizumab and/or bevacizumab) injections were included and analyzed in this retrospective case series. All patients were treated with an initial series of three monthly intravitreal anti-VEGF injections, followed by as-needed injections for a total of 36 months.

Results: The mean number of anti-VEGF injections was 9.61 ± 3.1 during the 36-month follow-up. Mean baseline best-corrected visual acuity (BCVA) was 0.79 ± 0.56 logarithm of the minimum angle of resolution (logMAR; 20/123 Snellen equivalent), and 0.75 ± 0.41 logMAR (20/112 Snellen equivalent) at 36 months (P = 0.55). Mean BCVA significantly improved at 3 months (P = 0.001), and the significant improvement persisted until 18 months from baseline (P = 0.02). However, the mean BCVA between 18 and 36 months showed no statistical in comparison with baseline values. Geographic atrophy developed in 14 eyes (36.8 %) during the entire 36-month follow-up period. Among baseline characteristics, baseline BCVA, greatest lesion diameter (GLD), and lesion size were significantly correlated with long-term visual outcome (P = 0.008, 0.02, and 0.002 respectively).

Conclusions: Intravitreal anti-VEGF injections for RAP showed a favorable visual outcome during the first year; however, the visual gains declined after the second year from baseline. Better baseline BCVA, smaller lesion size, and smaller baseline GLD are associated with better long-term visual outcomes in patients with RAP.

Keywords: Age-related macular degeneration; Geographic atrophy; Retinal angiomatous proliferation; Vascular endothelial growth factor.