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J. Whitehead, J.A. Elledge, B.A. Blodi, E. Reichel, TTT4CNV Study Group; Baseline Characteristics of Eyes With Retinal Angiomatous Proliferation (RAP) in the TTT4CNV Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1404.
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Purpose: To describe the angiographic and clinical features of 27 eyes at baseline which either had, or went on to develop, RAP during the course of the TTT4CNV study. This prospective study had 303 patients with small (<3mm diameter lesion) occult (<10% classic) subfoveal choroidal neovascular membranes at baseline, treated with either transpupillary thermotherapy (TTT) or sham therapy. Presence or absence of RAP features did not influence selection. Methods: 288 eyes in the TTT4CNV study were re–graded to document the presence or absence of eight photographic and/or angiographic features that may be associated with RAP. In all cases, stereoscopic color and red–free fundus photos and stereo fluorescein angiograms were used for evaluation. Features evaluated include those documented by Slakter and Yannuzzi et al1 as being characteristically associated with RAP, as well as reticular pseudo–drusen, a feature not previously associated with RAP. 20 eyes had 24 months of follow–up, 5 had 12 months follow–up, and two had 6 months follow–up. Results:27 eyes with gradeable photos and angiograms either had RAP at baseline or developed it during the study. Baseline features include: 26 of 27 (96%) of eyes had superficial retinal hemorrhages; 9 had a classic component to their CNV (33%), 12 had an angiographic "hot spot" (44%), 8 had a retinal–lesion anastomosis (30%), 6 had a serous pigment epithelial detachment (22%), 21 had lipid exudates (78%), 8 had a fibrovascular PED (30%), and 9 had reticular pseudo–drusen (33%). The one eye without definite superficial hemorrhage at baseline did demonstrate intraretinal blood at the three–month visit. Conclusions: Superficial retinal hemorrhages were a near–constant feature in eyes which developed or were to develop RAP. Active exudation, as evidenced by intra–retinal lipid, was a feature in three–fourths of the eyes. A surprising association was reticular pseudo–drusen, a rare lesion which was an associated feature in eyes with RAP in a third of the cases. 1. Slakter JS, Yannuzzi LA et al. Retinal choroidal anastomoses and occult choroidal neovascularization in age–related macular degeneration. Ophthalmol 2000;107:742–753
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