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A.L. Massacesi, L. Sacchi, F. Bergamini, F. Bottoni; The prevalence of Retinal Angiomatous Proliferation (RAP) in Age–related Macular Degeneration (ARMD) with Occult Choroidal Neovascularization (CNV). . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3105.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:dynamic Indocyanine Green Angiography (d–ICGA) has becoming increasingly important for the early diagnosis of RAP, often misinterpreted as type 1 (vascularized pigment epithelial detachment – PED) or type 2 (late leakage of undetermined source) occult CNV in patients with ARMD. Purpose of this study was to ascertain the prevalence of RAP in patients with ARMD and occult CNV by means of d–ICGA. Methods:we reviewed the clinical data of 253 consecutive patients (270 eyes) with a clinical diagnosis of type 1 or type 2 occult CNV on fluorescein angiography (FA) evaluated at our institution between 1998 and July 2003. All of them were examined with sequential digital fluorescein and ICG angiograms using a confocal scanning laser ophthalmoscope (Heidelberg Retinal Angiograph, Heidelberg Engeneering Gmbh, Germany). Results:of 253 patients, 165 were women (65%) and 83 were men (35%). The mean age was 70 years. 60 eyes (22%) had a vascularized PED (type 1) and 210 (78%) a type 2 occult CNV with d–ICGA. We identified 57 RAP in 54 eyes (21%). The RAPs were in 6 of 60 eyes with type 1 (10%) and 51 of 210 eyes with type 2 occult CNV (24%). The mean distance of the lesions from the fovea was 682 ± 304 µm (mean ± SD). In 47 % of the cases the RAP was located inferior to the fovea, in 33% superior and in 10.5% of the cases temporal to the fovea. RAPs were visible only with d–ICGA in 65% of the patients examined whereas they were also visible on FA in 21% of the cases. The mean dimension of the RAP was 668 ± 453 µm (mean ± SD). Conclusions:our study shows the importance of d–ICGA for the early diagnosis of RAP in exudative ARMD. In our series up to ¼ of type 2 occult CNV were in fact RAP. This is consistent with the only paper published in the literature about the prevalence of RAP in exudative ARMD (Axer–Siegel R. et al., Ophthalmology, 109: 1726, 2002).
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