Visual outcome of retinal angiomatous proliferation in Chinese patients following photodynamic therapy or direct laser photocoagulation

Abstract

Aims: To report the prevalence of retinal angiomatous proliferation in Chinese patients presenting with neovascular age-related macular degeneration and to evaluate the outcomes following photodynamic therapy or laser photocoagulation.

Methods: This was a retrospective review of patients who presented with neovascular age-related macular degeneration to a tertiary eye hospital from January 2005 to December 2005. Patients with retinal angioma- tous proliferation were identified based on fluorescein angiography, indocyanine green angiography, and their medical records. Clinical outcomes of patients with retinal angiomatous proliferation during the follow-up period were analyzed.

Results: Of the 104 patients reviewed, 7 eyes of 7 patients (6.7%) were found to have retinal angiomatous proliferation. Five eyes (71.4%) had stage 2 retinal angiomatous proliferation and 2 (28.6%) had stage 3 retinal angiomatous proliferation. Three eyes were treated by photodynamic therapy with or without intravitreal triamcinolone acetonide, 1 eye was treated with laser photocoagulation, and 3 eyes were managed by observation alone. After a mean follow-up of 17 months, the median best-corrected visual acuity decreased from 20/160 to 20/400 (p = 0.043). Five patients (71.4%) developed visual loss and 2 (28.6%) had stable vision at the last follow-up.

Conclusions: Retinal angiomatous proliferation ap- peared to be less frequent in Chinese patients with neovascular age-related macular degeneration than in Caucasians. The visual outcomes for retinal angioma- tous proliferation following photodynamic therapy and laser photocoagulation are generally poor and other therapeutic options should be considered.