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A. Sehgal, H.J. Kaplan, C.C. Barr, T. Tezel; Is Choroidal Ischemia the Cause for Retinal Angiomatous Proliferation? . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5167.
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To investigate the perfusion status of subfoveal choroid in patients with retinal angiomatous proliferation (RAP) in comparison with age–matched patients with exudative age related macular degeneration(AMD) without any evidence of RAP.
Fluorescein angiography (FA) and indocyanine green angiography (ICG) of 10 patients with RAP and 10 patients with other forms of exudative AMD are examined retrospectively to determine the perfusion status of the subfoveal choriod. Choroid perfusion defects were defined as patchy areas of hypofluorescence underneath the fovea not related to any blocking defect and persists throughout the fluorescein transit time. Perfusion status of the choroid was assessed by two independent observers in a blind fashion. Confounding effects of relative hypofluorescence due to pigment epithelial detachments were avoided by comparing its borders with the extent of choriocapillaris filling defects. Densitometric analysis were done in doubtful cases to differentiate the fluorescein intensities
Average age of the RAP cases were similar to non–RAP patients. 7/10 (70%) of eyes with RAP had evidence of foveal choroidal perfusion defects in the vicinity of RAP on ICG/FA compared to only 1/10 (10%) patients with AMD.
Our results indicate that patients with RAP have a significantly higher rate of choroidal filling defects. Choroidal ischemia may create the angiogenic stimulus and induce unidirectional growth of retinal neovascularization towards the subfoveal space.
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