Abstract
Background
We report the postoperative outcomes of surgical neovascularization excision in patients with retinal angiomatous proliferation (RAP).
Methods
Nine eyes of eight patients with RAP who underwent surgical excision of neovascularization were studied. Surgical indications were as follows: RAP diagnosed by fluorescein and indocyanine green angiography, foveal or perifoveal neovascularization, preoperative visual acuity of 0.1 or less, Yannuzzi’s stage II with detachment of retinal pigment epithelium (RPE) or stage III, and leakage on late-phase fluorescein angiography. After cataract surgery, vitreous surgery and neovascularization excision were conducted, followed by fluid–air or fluid–gas exchange.
Results
Visual acuity was 0.02–0.1 before surgery and 0.03–0.2 after surgery. Macular hole formation was seen in one eye but did not lead to retinal detachment. In two eyes, subretinal bleeding occurred during excision leading to vitreous bleeding after surgery. Although defects of the RPE and choriocapillaries were observed after surgery, the exudation and bleeding were absorbed.
Conclusions
In stage II RAP cases with RPE detachment, surgical excision maintains constant postoperative visual acuity but results in defects of RPE and choriocapillaris; therefore, other treatment options should be examined. Surgical excision of stage III RAP seems to be promising, as postoperative visual acuity remains stable after neovascularization removal in those advanced pathologic situations.
Similar content being viewed by others
References
Arai K, Yuzawa M (2004) Therapeutic outcome in retinal angiomatous proliferation. Jpn J Clin Ophthalmol 58:1423–1428
Borrillo JL, Sivalingam A, Martidis A, et al (2003) Surgical ablation of retinal angiomatous proliferation. Arch Ophthalmol 121:558–561
Gass JDM, Agarwal A, Lavina AM, et al (2003) Focal inner retinal hemorrhages in patients with drusen. An early sign of occult choroidal neovascularization and chorioretinal anastomosis. Retina 23:741–751
Ghazi NG, Yannuzzi LA (2002) Correspondence. Retinal angiomatous proliferation in age-related macular degeneration. Retina 22:509–512
Hartnett ME, Weiter JJ, Garsd A, et al (1992) Classification of retinal pigment epithelial detachments. Graefes Arch Clin Exp Ophthalmol 230:11–19
Kuroiwa S, Arai J, Gaun S, et al (2003) Rapidly progressive scar formation after transpupillary thermotherapy in retinal angiomatous proliferation. Retina 23:417–420
Lafaut BA, Aisenbrey S, van den Broeckel CV, et al (2000) Clinicopathological correlation of deep retinal vascular anomalous complex in age-related macular degeneration. Br J Ophthalmol 84:1269–1274
Shimada H, Isomae T, Shimizu S, et al (2000) Influence of factors on visual acuity following vitrectomy for exudative age-related macular degeneration. J Jpn Ophthalmol Soc 104:489–494
Slakter JS, Yannuzzi LA, Schneider U, et al (2000) Retinal choroidal anastomoses and occults choroidal neovascularization in age-related macular degeneration. Ophthalmology 107:742–754
Thomas MA, Dickinson JD, Melberg NS, et al (1994) Visual results after surgical removal of subfoveal choroidal neovascular membranes. Ophthalmology 101:1384–1396
Yannuzzi LA, Negrao S, Iida T, et al (2001) Retinal angiomatous proliferation in age-related macular degeneration. Retina 21:416–434
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shimada, H., Mori, R., Arai, K. et al. Surgical excision of neovascularization in retinal angiomatous proliferation. Graefe's Arch Clin Exp Ophthalmol 243, 519–524 (2005). https://doi.org/10.1007/s00417-004-1073-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-004-1073-x