Retinal angiomatous proliferation: Clinical characteristics and treatment options

Megan A. Hunter, Mark T. Dunbar, Phillip J. Rosenfeld

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background: A new form of exudative age-related macular degeneration (ARMD), retinal angiomatous proliferation (RAP), has been described in which neovascularization begins in the deep retina, extends through the subretinal space, and eventually communicates with choroidal neovascularization. Methods: Case series. Results: Common clinical features of RAP include small multiple intra-retinal hemorrhages, intra-retinal edema, vascularized pigment epithelial detachments (PEDs), and retinal choroidal anastomosis (RCA). Fluorescein angiography (FA) reveals ill-defined, occult choroidal neovascularization. Indocyanine green (ICG) angiography is useful in early stages because 'hot spots' can be detected before clinical or FA characteristics are present. Optical coherence tomography (OCT) is useful in illustrating some of the clinical and FA characteristics. The use of photodynamic therapy (PDT), combined with intravitreal triamcinolone injection, was successful in stabilizing the RAP lesion in one case discussed in this report. Conclusions: Retinal angiomatous proliferation is a newly recognized entity of exudative age-related macular degeneration with its own set of clinical, FA, ICG angiography, and OCT features. Experimental treatments such as the use of PDT combined with intravitreal triamcinolone injection demonstrate potential success with this entity. The biggest hope appears to be anti-angiogenic factors currently in clinical trials for the treatment of exudative ARMD.

Original languageEnglish (US)
Pages (from-to)577-588
Number of pages12
JournalOptometry
Volume75
Issue number9
DOIs
StatePublished - Sep 2004

Keywords

  • Age-related macular degeneration
  • Choroidal neovascularization
  • Fluorescein angiography
  • Indocyanine green angiography
  • Intraretinal neovascularization
  • Optical coherence tomography
  • Pigment epithelial detachment

ASJC Scopus subject areas

  • Health Professions(all)

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