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Retinal Pigment Epithelial Detachment in Retinal Angiomatous Proliferation

  • Maria Andreea GamulescuEmail author
Chapter

Abstract

Retinal angiomatous proliferation (RAP) is a distinct subtype of age-related macular degeneration (AMD) with specific features in fundoscopy and imaging. Still, there is controversy about the origin of these lesions, namely, retinal or choroidal vasculature. Retinal pigment epithelial detachment (PED) and retino-choroidal anastomosis can develop over time and are the hallmark of late-stage disease. Although many names have been proposed for this entity, their common feature is the intraretinal vascular proliferation and exudation and therefore, the term “RAP” is widely accepted.

References

  1. 1.
    Kürzinger GR, Lang GK, Lang GE. Retinal angiomatous proliferation in age-related macular degeneration. Klin Monbl Augenheilkd. 2006;223(8):691–5.CrossRefGoogle Scholar
  2. 2.
    Massacesi AL, Sacchi L, Bergamini F, Bottoni F. The prevalence of retinal angiomatous proliferation in age-related macular degeneration with occult choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol. 2008;246:89–92.CrossRefPubMedGoogle Scholar
  3. 3.
    Slakter JS, Yannuzzi LA, Schneider U, Sorenson JA, Ciardella A, Guyer DR, Spaide RF, Freund KB, Orlock DA. Retinal choroidal anastomoses and occult choroidal neovascularization in age-related macular degeneration. Ophthalmology. 2000;107:742–54.CrossRefPubMedGoogle Scholar
  4. 4.
    Kuhn D, Meunier I, Soubrane G, Coscas G. Imaging of chorioretinal anastomoses in vascularized retinal pigment epithelium detachments. Arch Ophthalmol. 1995;113(11):1392–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Jung JJ, Chen CY, Mrejen S, Gallogo-Pinazo R, Xu L, Marsiglia M, Boddu S, Freund KB. The incidence of neovascular subtypes in newly diagnosed neovascular age-related macular degeneration. Am J Ophthalmol. 2014;158:769–79.CrossRefPubMedGoogle Scholar
  6. 6.
    Axer-Siegel R, Bourla D, Priel E, et al. Angiographic and flow patterns of retinal choroidal anastomoses in age-related macular degeneration with occult choroidal neovascularization. Ophthalmology. 2002;109:1726–36.CrossRefPubMedGoogle Scholar
  7. 7.
    Song SJ, Youm DJ, Chang Y, Yu HG. Age-related macular degeneration in a screened South Korean population: prevalence, risk factors, and subtypes. Ophthalmic Epidemiol. 2009;16(5):304–10.CrossRefPubMedGoogle Scholar
  8. 8.
    Maruko I, Iida T, Saito M, Nagayama D, Saito K. Clinical characteristics of exudative age-related macular degeneration in Japanes patients. Am J Ophthalmol. 2007;44:15–22.CrossRefGoogle Scholar
  9. 9.
    Hartnett ME, Weiter JJ, Gardts A, Jalkh AE. Classification of retinal pigment epithelial detachments associated with drusen. Graefes Arch Clin Exp Ophthalmol. 1992;230:11–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Yannuzzi LA, Negrao S, Iida T, et al. Retinal angiomatous proliferation in age-related macular degeneration. Retina. 2001;21:416–34.CrossRefPubMedGoogle Scholar
  11. 11.
    Gass JDM, AgarwalA LA, et al. Focal inner retinal hemorrhages in patients with drusen: an early sign of occult choroidal neovascularization and chorioretinal anastomosis. Retina. 2003;23:741–51.CrossRefPubMedGoogle Scholar
  12. 12.
    Brancato R, Introini U, Piero L, et al. Optical coherence tomography (OCT) in retinal angiomatous proliferation (RAP). Eur J Ophthalmol. 2002;12:467–72.Google Scholar
  13. 13.
    Costa RA, Calucci D, Paccola L, et al. Occult chorioretinal anastomosis in age-related macular degeneration: a prospective study by optical coherence tomography. Am J Ophthalmol. 2005;140:107–16.CrossRefPubMedGoogle Scholar
  14. 14.
    Truong SN, Alam S, Zawadzki RJ, Choi SS, Telander DG, Park SS, Werner JS, Morse LS. High resolution fourier-domain optical coherence tomograph of retinal angiomatous proliferation. Retina. 2007;27:915–25.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Lafaut BA, Aisenbrey S, Broecke CV, et al. Clinicopathological correlation of deep retinal vascular anomalous complex in age-related macular degeneration. Br J Ophthalmol. 2000;84:1269–74.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Shimada H, Kawamura A, Mori R, Yuzawa M. Clinicopathological findings of retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol. 2007;245:295–300.CrossRefPubMedGoogle Scholar
  17. 17.
    Monson DM, Smith JR, Klein ML, Wilson DJ. Clinicopathologic correlation of retinal angiomatous proliferation. Arch Ophthalmol. 2008;126:1664–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Okamoto N, Tobe T, Hackett SF, Ozaki H, Vinores MA, LaRochelle W, et al. Transgenic mice with increased expression of vascular endothelial growth factor in the retina: a new model of intraretinal and subretinal neovascularization. Am J Pathol. 1997;151:281–91.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Tobe T, Okamoto N, Vinores MA, Derevjanik NL, Vinores SA, Zack DJ, Campochiaro PA. Evolution of neovascularization in mice with overexpression of vascular endothelial growth factor in photoreceptors. Invest Ophthalmol Vis Sci. 1998;39(1):180–8.PubMedGoogle Scholar
  20. 20.
    Freund KB, Ho IV, Barbazetto IA, Koizumi H, Laud K, et al. Type 3 neovascularization. The expanded spectrum of retinal angiomatous proliferation. Retina. 2008;28:201–11.CrossRefPubMedGoogle Scholar
  21. 21.
    Yannuzzi LA, Freund KB, Takahashi BS. Review of retinal angiomatous proliferation or type 3 neovascularization. Retina. 2008;28:375–84.CrossRefPubMedGoogle Scholar
  22. 22.
    Klein R, Davis MD, Magli YL, et al. The Wisconsin age-related maculopathy grading system. Ophthalmology. 1991;98(7):1128–34.CrossRefPubMedGoogle Scholar
  23. 23.
    Arnold JJ, Sharks SH, Killingsworth MC, et al. Reticular pseudodrusen. A risk factor in age-related maculopathy. Retina. 1995;15(3):183–91.CrossRefPubMedGoogle Scholar
  24. 24.
    Klein R, Meuer SM, Knudtson MD, Iyengar SK, Klein BEK. The epidemiology of retinal reticular drusen. Am J Ophthalmol. 2008;145(2):317–26.CrossRefPubMedGoogle Scholar
  25. 25.
    Ueta-Arakawa N, Ooto S, Nakatta I, et al. Prevalence and genomic association of reticular pseudodrusen in age-related macular degeneration. Am J Ophthalmol. 2013;155:260–9.CrossRefGoogle Scholar
  26. 26.
    Sawa M, Ueno C, Gomi F, Nishida K. Incidence and characteristics of neovascularization in fellow eyes of Japanese patients with unilateral retinal angiomatous proliferation. Retina. 2014;34:761–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Cohen SY, Dubois L, Tadayoni R, et al. Prevalence of reticular pseudodrusen in age-related macular degeneration with newly diagnosed choroidal neovascularization. Br J Ophthalmol. 2007;91:354–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Saito M, Iida T, Kano M, Itagaki K. Two-year results of combined intravitreal ranibizumab and photodynamic therapy for retinal angiomatous proliferation. Jpn J Ophthalmol. 2016;60:42–50.CrossRefPubMedGoogle Scholar
  29. 29.
    De Bats F, Mathis T, Mauget-Faÿsse M, Joubert F, Denis P, Kodjikian L. Prevalence of reticular pseudodrusen in age-related macular degeneration using multimodal imaging. Retina. 2016;36(1):46–52.CrossRefPubMedGoogle Scholar
  30. 30.
    Polito A, Napolitano MC, Bandello F, Chiodini RG. The role of optical coherence tomography (OCT) in the diagnosis and management of retinal angiomatous proliferation (RAP) in patients with age-related macular degeneration. Ann Acad Med Singapore. 2006;35:420–4.Google Scholar
  31. 31.
    Rouvas AA, Papakostas TD, Ntouraki A, Douvali M, Vergados I, Ladas ID. Angiographic and OCT features of retinal angiomatous proliferation. Eye. 2010;24:1633–43.CrossRefPubMedGoogle Scholar
  32. 32.
    Bottoni F, Massacesi A, Cigada M, Viola F, Musicco I, Staurenghi G. Treatment of retinal angiomatous proliferation in age-related macular degeneration: a series of 104 cases of retinal angiomatous proliferation. Arch Ophthalmol. 2005;123:1644–50.CrossRefPubMedGoogle Scholar
  33. 33.
    Viola F, Massacesi A, Orzalesi N, Ratiglia R, Staurenghi G. Retinal angiomatous proliferation: natural history and progression of visual loss. Retina. 2009;29:732–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Cho HJ, Kim HS, Yoo SG, Han JI, Lew YJ, Cho SW, Lee TG, Kim JW. Retinal pigment epithelial tear after intravitreal ranibizumab treatment for retinal angiomatous proliferation. Am J Ophthalmol. 2015a;160(5):1000–5.CrossRefPubMedGoogle Scholar
  35. 35.
    Cho HJ, Yoo SG, Kim HS, Kim JH, Kim CG, Lee TG, et al. Risk factors for geographic atrophy after intravitreal ranibizumab injections for retinal angiomatous proliferation. Am J Ophthalmol. 2015b;159:285–92.CrossRefPubMedGoogle Scholar
  36. 36.
    Sutter FK, Kurz-Levin MM, Fleischhauer J, Bösch MM, Barthelmes D, Helbig H. Macular atrophy after combined intravitreal triamcinolone acetonide (IVTA) and photodynamic therapy (PDT) for retinal angiomatous proliferation (RAP). Klin Monbl Augenheilkd. 2006;223:376–8.CrossRefPubMedGoogle Scholar
  37. 37.
    McBain VA, Kumari R, Townend J, Lois N. Geographic atrophy in retinal angiomatous proliferation. Retina. 2011;31:1043–52.CrossRefPubMedGoogle Scholar
  38. 38.
    Gross NE, Aizman A, Brucker A, Klancnik Jr JM, Yannuzzi LA. Nature and risk of neovascularization in the fellow eye of patients with unilateral retinal angiomatous proliferation. Retina. 2005;25:713–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Macular Photocoagulation Study Group. Five-year follow-up of fellow eyes of patients with age-related macular degeneration and unilateral extrafoveal choroidal neovascularization. Arch Ophthalmol. 1993;111:1189–99.CrossRefGoogle Scholar
  40. 40.
    Campa C, Harding SP, Pearce IA, Beare NAV, Briggs MC, Heimann H. Incidence of neovascularization in the fellow eye of patients with unilateral retinal angiomatous proliferation. Eye. 2010;24:1585–9.CrossRefPubMedGoogle Scholar
  41. 41.
    Barbazetto IA, Kumar K, Karamchandani H, Rabinowitz D, Takahashi B, Yannuzzi LA. Risk for choroidal neovascularization in the fellow eye of patients on anti-VEGF therapy for age-related macular degeneration. Invest Ophthalmol Vis Sci. 2008;49:2227. E Abstract 256.Google Scholar
  42. 42.
    Bottoni F, Cigada M, Romano M, et al. The incidence of retinal angiomatous proliferation in the fellow eye. Updated findings. IOVS. 2006; ARVO abstract 2177.Google Scholar
  43. 43.
    Marques MF, Marques JP, Gil JQ, Costa J, Almeida E, Cachulo Mda L, Pires I, Figueira J, Silva R. Long-term management of RAP lesions in clinical practice: treatment efficacy and predictors of functional improvement. Ophthalmic Res. 2016;55(3):119–25.CrossRefPubMedGoogle Scholar
  44. 44.
    Johnson TM, Glaser BM. Focal laser ablation of retinal angiomatous proliferation. Retina. 2006;26(7):765–72.CrossRefPubMedGoogle Scholar
  45. 45.
    Konstantinidis L, Mameletzi E, Mantel I, Pournaras JA, Zografos L, Ambresin A. Intravitreal ranibizumab (Lucentis) in the treatment of retinal angiomatous proliferation (RAP). Graefes Arch Clin Exp Ophthalmol. 2009;247(9):1165–71.CrossRefPubMedGoogle Scholar
  46. 46.
    Cho HJ, Lee TG, Han SY, Kim HS, Kim HJ, Han JI, Lew YJ, Kim JW. Long-term visual outcome and prognostic factors of intravitreal anti-vascular endothelial growth factor treatment for retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol. 2016;254(1):23–30.CrossRefPubMedGoogle Scholar
  47. 47.
    Daniel E, Shaffer J, Ying GS, Grunwald JE, Martin DF, Jaffe GJ, et al. Outcomes in eyes with retinal angiomatous proliferation in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). Ophthalmology. 2016;123(3):609–16. doi: 10.1016/j.ophtha.2015.10.034.

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department OphthalmologyUniversity HospitalRegensburgGermany

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