The Characteristics of Neovascularization in the Fellow Eye of Patients with Unilateral Retinal Angiomatous Proliferation

Abstract

Abstract: : Purpose: To characterize the neovascular process that develops in the uninvolved fellow eyes of patients with unilateral symptomatic retinal angiomatous proliferation (RAP), a form of neovascular age–related macular degeneration (AMD). Methods: A retrospective case series involving 77 patients with RAP in one eye (77 eyes) some of whom went on to develop neovascular AMD in the fellow eye. Clinical biomicroscopic examination, fluorescein angiography, and indocyanine green angiography were used to evaluate eyes. Results: Neovascular AMD developed in the fellow eye of 52 patients (68%) over a mean follow–up of 26 months. The neovascularization was characterized in the following manner: presence and size of intraretinal, preretinal, and subretinal hemorrhages, RPE atrophy, subretinal fluid, fibrosis and scarring, cystoid macular edema, retinal pigment epithelial rips, serous pigment epithelial detachments, vascular pigment epithelial detachments, total lesion size, and greatest linear dimension. Conclusions: Patients with unilateral, symptomatic RAP lesions frequently go on to develop neovascular AMD in the fellow previously uninvolved eye. Characterization of the neovascular process may help in the diagnosis, management, and treatment of patients with this disorder.

Keywords: age–related macular degeneration • neovascularization • retina