Tomographic features of intraretinal neovascularization in retinal angiomatous proliferation

The purpose of this study was to define the origin of intraretinal neovascularization in retinal angiomatous proliferation with spectral domain-optical coherence tomography.

We retrospectively studied nine consecutive eyes of seven patients (two eyes of two men, seven eyes of five women) with untreated retinal angiomatous proliferation using fluorescein and indocyanine green angiography and spectral domain-optical coherence tomography. One eye had stage I disease, two eyes had stage II disease with no pigment epithelial detachment, and six eyes had stage II disease with pigment epithelial detachment. We evaluated the location of the intraretinal neovascularization, disruption of the retinal pigment epithelium, retinal edema, and serous retinal detachments.

Intraretinal neovascularization appeared as a highly reflective mass from the outer plexiform layer to the deeper layer in seven eyes. The underlying retinal pigment epithelium was disrupted beneath the intraretinal neovascularization in all eyes. All eyes had retinal edema around the intraretinal neovascularization. Serous retinal detachments were seen in only two eyes with stage II disease with pigment epithelial detachment. Intraretinal neovascularization originated outside the foveal avascular zone in all eyes.

Intraretinal neovascularization seems to originate from the deep retinal capillaries at the outer plexiform layer and grow toward the retinal pigment epithelium.