Abstract
Purpose: :
To describe the retinal changes before the development of retinal angiomatous proliferation (RAP) in the fellow eye of patients with unilateral RAP.
Methods: :
Retrospective review of 23 consecutive patients (24 eyes) who had been treated in the first eye for RAP and whose fellow eye was free of lesion at the first examination. Patients underwent clinical biomicroscopic examination, dynamic fluorescein and indocyanine green angiography with stereo angiograms using a confocal Scanning Laser Ophthalmoscope ( SLO, HRA-Heidelberg Engineering, Heidelberg, Germany) and Spectral Domain OCT (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany and Cirrus HD OCT, Carl Zeiss Meditec, Inc., USA). We analyzed by OCT and ICGA the preexisting retinal features in the specific point where the RAP developed.
Results: :
Of the 23 patients (24 eyes), 13 were females and 10 males. Mean age was 77 years (range 67-86). During a mean follow-up of 22 months (range, 1-44), 11 RAP developed in the fellow eye (45%). On OCT images 7 eyes showed a focal area of photoreceptor atrophy (63%), 6 eyes retinal pigment epithelium (RPE) detachment with mottling of RPE (54%) and all the eyes reticular drusen. On ICGA images 8 eyes showed choroidal hypofluorescence (89%).
Conclusions: :
Choroidal hypofluorescence seems to be strongly associated with the development of RAP lesion. On OCT images, focal area of photoreceptor atrophy and RPE detachment with mottling of RPE seem to be retinal changes preceding RAP development.
Keywords: age-related macular degeneration • imaging/image analysis: clinical • retina