High Resolution Fourier-Domain Optical Coherence Tomography of Retinal Angiomatous Proliferation

Abstract

Purpose:: To study the anatomical details of retinal angiomatous proliferation (RAP) in patients with age-related macular degeneration (ARMD) using high-resolution Fourier-domain optical coherence tomography (Fd-OCT) and its three-dimensional reconstructions.

Methods:: A Fd-OCT instrument was used to image 5 patients clinically diagnosed with RAP. A series of 100 raster-scanned B-scans centered over the macula was registered and rendered as a three dimensional (3-D) volume. These retinal structures were analyzed for anatomical details of the RAP lesions.

Results:: The RAP lesion could be identified within the retina on Fd-OCT in all five cases. Fd-OCT images of the first four cases revealed areas of intraretinal neovascularization (IRN) in the deep retina adjacent to a pigment epithelial detachment (PED). There was neovascular proliferation anteriorly and posteriorly through a break in the retinal pigment epithelium (RPE). In three of the four cases, Bruch’s membrane remained intact. There was no identifiable choroidal neovascularization (CNV). The fifth case had both subretinal and sub-RPE neovascular membranes without a PED.

Conclusions:: Fd-OCT provides unprecedented in-vivo detail of the anatomy of RAP lesions that nearly resembles histological specimens. Our study suggests that the initial neovascular process in RAP can originate either within the retina or in the sub-RPE space.

Keywords: age-related macular degeneration • imaging/image analysis: clinical • retinal neovascularization