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Preparation of Mouse Retinal Cryo-sections for Immunohistochemistry
Published on: July 1, 2019
Bilateral Retinal Angiomatous Proliferation in a Variant of Retinitis Pigmentosa
G Aloe1, C M De Sanctis1, C Strafella2,3
1Unit Retinal Pathology PTV Foundation, Tor Vergata University, Rome, Italy.
Purpose:
To describe the first case of bilateral retinal angiomatous proliferation (RAP) in a patient with a variant of retinitis pigmentosa (RP).
Case Report:
An 85-year-old man with RP presented with visual acuity decrease and metamorphopsia in the left eye (LE). Fundus examination revealed typical signs of RP in both eyes, associated with intraretinal macular hemorrhage in the LE. Multimodal imaging, using Colour fundus Photography, Fluorescein (FA), and Indocyanine Green Angiography (ICGA) as well as Spectral-Domain Optical Coherence Tomography (SD-OCT) and Optical Coherence Tomography Angiography (OCTA), revealed a type 3 neovascular lesion in the involved eye. Genetic testing (NGS analysis) was performed to search for genetic variants correlated with the disease phenotype displayed by the patient. The patient was treated with intravitreal injections of bevacizumab, according to a fixed protocol of bimonthly injections plus a booster dose at second month. After 9 months, he was referred for visual acuity decrease and metamorphopsia in the fellow eye, where SD-OCT/OCTA showed a type 3 neovascular lesion in the right eye (RE). He was scheduled for intravitreal injections of bevacizumab. In both eyes, treatment with intravitreal bevacizumab was successful.
Insights
This case report details the first instance of bilateral retinal angiomatous proliferation (RAP) in a patient with retinitis pigmentosa (RP). Intravitreal bevacizumab injections successfully treated the condition in both eyes.
Area of Science:
- Ophthalmology
- Medical Genetics
- Retinal Diseases
Background:
- Retinitis pigmentosa (RP) is a group of inherited retinal diseases.
- Retinal angiomatous proliferation (RAP) is an uncommon neovascular complication of age-related macular degeneration.
- Bilateral occurrence of RAP in RP is exceptionally rare.
Observation:
- An 85-year-old male with RP presented with decreased vision and metamorphopsia.
- Fundus examination revealed RP signs in both eyes and macular hemorrhage in the left eye.
- Multimodal imaging confirmed type 3 neovascular lesions (RAP) in both eyes.
Findings:
- The patient was diagnosed with bilateral retinal angiomatous proliferation (RAP), a variant of neovascular AMD, in the context of retinitis pigmentosa (RP).
- Genetic testing (NGS analysis) was performed to identify potential genetic correlations.
- Intravitreal bevacizumab injections were administered bimonthly with a booster dose, leading to successful treatment in both eyes.
Implications:
- This case highlights a novel association between RP and bilateral RAP.
- It suggests that patients with RP may be susceptible to developing RAP.
- Effective treatment with intravitreal bevacizumab was demonstrated for this rare presentation.
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