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EM Shrier, JJ Huang, A Ciardella, LA Yannuzzi; Characteristics of the Fellow Eye in Patients with Retinal Angiomatous Proliferation (RAP) . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1230.
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Purpose: To identify characteristics of the fellow eyes in patients presenting with vision loss due to unilateral retinal angiomatous proliferation (RAP), and those with classical exudative AMD, which may serve to aid in the differentiation of the various etiologies of choroidal neovascularization (CNV) at time of presentation. This may allow for early, accurate diagnosis and specific, timely followup and treatment. Methods: Case control, prospective analysis of color, stereo-photo and fluorescein angiographic features in the fellow eyes of 30 patients presenting with acute vision loss due to RAP were contrasted with 30 patients with exudative AMD and evidence of leakage due to choroidal neovascularization. Results: The two groups did not differ with respect to demographics. 23 of 30 patients presenting with RAP lesions had significantly more (≷ 20) large, soft drusen in their fellow eye as compared to those with classical AMD (p<.05). They were also more likely to exhibit confluence of these drusen (22 of 30; p<.05). A number of RAP second eyes (9 of 30) exhibited a localized, pigmentary response suggestive of lipofuscin, which blocked fluorescence on late-phase IVFA. Conclusion: We have identified several features in the fellow eye of AMD patients, which serve to distinguish RAP from non-RAP, exudative AMD. It is important to diagnose RAP in the form of early and treatable, intraretinal neovascularization. This has important clinical implications for the management of patients with exudative AMD.
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