Purpose: To present functional and anatomic outcomes of combination
therapy with ranibizumab and photodynamic therapy (PDT) in a series of
retinal angiomatous proliferation (RAP) cases. Methods: A total of 17
eyes of 17 patients with RAP were included. Thirteen eyes were treatment
naive and 4 were already on ranibizumab monotherapy. Combined treatment
with single-dose ranibizumab and PDT was performed on all
treatment-naive cases. Follow-up was performed every month for 6-38
months, using optical coherence tomography and indocyanine green
angiography when necessary. Results: Overall, 6 out of 7 treatment-naive
cases with stage I or II disease manifested complete angiographic
resolution of the hot spot with a single injection of ranibizumab plus
PDT. In stage III disease, 7 out of 10 eyes showed persistent leakage
immediately after the combined treatment. The rate of hot spot occlusion
was found to correlate with the stage of disease (p = 0.05). There was a
significant improvement in posttreatment BCVA for all patients
regardless of disease stage (p = 0.02), which was more evident in the
earlier stages. Improvement was also greater for treatment-naive
patients (p = 0.03). The posttreatment improvement in BCVA was strongly
correlated with hot spot occlusion (p < 0.001). Conclusions: Single-dose
modified anti-VEGF treatment in combination with PDT may provide
long-term regression at the initial stages of RAP
