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RETINAL ANGIOMATOUS PROLIFERATION DIAGNOSIS: A Multiimaging Approach
Vittoria Ravera1, Ferdinando Bottoni, Andrea Giani
1Eye Clinic, Department of Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
Retina (Philadelphia, Pa.)
|November 22, 2016
Summary
Retinal angiomatous proliferation (RAP) shows distinct signs like blood flow shunting and intraretinal cysts compared to other choroidal neovascularization (CNV) in age-related macular degeneration. Multimodal imaging aids in differentiating these neovascularization subtypes.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Age-related macular degeneration (AMD) is a leading cause of vision loss.
- Choroidal neovascularization (CNV) is a key feature of wet AMD.
- Distinguishing subtypes of CNV, such as retinal angiomatous proliferation (RAP), is crucial for effective management.
Purpose of the Study:
- To identify specific imaging signs associated with retinal angiomatous proliferation (RAP) lesions.
- To compare the frequency of these signs in RAP versus other types of choroidal neovascularization (CNV).
- To evaluate the utility of multimodal imaging in differentiating CNV subtypes in AMD.
Main Methods:
- A retrospective cross-sectional study involving 30 patients with AMD.
- Evaluation of specific signs using fluorescein angiography (FA), indocyanine green angiography (ICGA), spectral domain optical coherence tomography (SD-OCT), and infrared imaging.
- Correlation of identified signs with CNV subtypes: RAP and others.
Main Results:
- Blood flow shunting was observed in 56% of RAP cases and 0% of other CNVs.
- Late leakage on ICGA occurred in 100% of RAP cases versus 7% of other CNVs.
- Intraretinal cysts (100% RAP vs. 14% others), RPE interruption (93% RAP vs. 15% others), and reticular pseudodrusen (87% RAP vs. 21% others) were significantly more frequent in RAP.
Conclusions:
- The investigated signs are strongly associated with RAP lesions.
- Multimodal imaging is valuable for differentiating RAP from other CNV subtypes in AMD.
- Accurate classification of CNV subtypes can potentially improve treatment strategies.
