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

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

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