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M. Setaccioli, U. Introini, S. M. Giatsidis, A. Torres Gimeno, F. Scotti, L. Pierro, F. Bandello; Retinal Angiomatous Proliferation (RAP) vs. Occult Choroidal Neovascularization (O-CNV) in Exudative Age-Related Macular Degeneration Evaluated With SD Optical Coherence Tomography (SDOCT) Before and After Ranibizumab Treatment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):336.
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to evaluate macular morphology in RAP and O-CNV using SDOCT before and after intravitreal Ranibizumab treatment.
retrospective case series. Twenty-six eyes of 26 consecutive patients affected by AMD (7 RAP type II and 19 O-CNV) were included. Clinical evaluation and SDOCT line foveal scans and retinal maps were obtained at baseline and after the loading phase. Normal retinal morphology corresponding to the inner retinal layers, the external limiting membrane (ELM), the IS/OS junction and retinal pigment epithelium (RPE), as well as the pathologic findings corresponding to hypereflective dots, hyper- or hypo- reflective fluid and pigment epithelial detachment (PED) were graded as "present or normal": 1, or "absent or altered": 0 - Chi-square test (95% CI) and T-test (95% CI).
in O-CNV mean logMAR visual acuity was 0.38 at baseline and 0.35 after Ranibizumab loading phase, 0.39 and 0.25 in RAP group. At baseline inner retinal layers were altered in 100% RAP group and in 52.6% O-CNV (p= 0.024). RPE was normal in 71.4 % of RAP group and in 26.3% of O-CNV group (p=0.036). After the loading phase, intra- and subretinal fluid, PED and central foveal thickness were statistically decreased in the RAP group (p=0.002; 0.027 and 0.048 respectively). Compared to baseline, the O-CNV statistically lost hypereflective dots (p=0.005) and hyper reflective-fluid (p=0.003); RAP group recovered the inner retinal layers morphology (p=0.018). 31.6% of O-CNV and 57% of RAP recovered IS/OS junction integrity (p= 0.008 and p=0.018 respectively).
compared to O-CNVs, RAPs show better short-term functional and morphological recovery after the Ranibizumab loading phase. This might be due to the smaller dimension, the juxtafoveal location and the intraretinal position of the RAPs. Further investigation and longer follow-up are warranted.
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