Retinal angiomatous proliferation associated with risk alleles of arms2htra1 gene polymorphisms in japanese patients yasuhiro ohkuma,1 takaaki hayashi,1 tsutomu sakai,1 akira watanabe,1 hisashi yamada,2 masakazu akahori,3 takeshi itabashi,3 takeshi iwata,3 toru noda,4 hiroshi tsuneoka11department of ophthalmology, 2department of molecular genetics, institute of dna medicine, the jikei. Around 2 years later, gass 6 proposed a fivestage development and advocated in favor of the choroidal origin of this lesion naming it occult chorioretinal anastomosis. It is characterized by peculiar hemorrhagic lesions accompanied by exudation and retinal microangiopathic changes in which is new vessels grow from the choroid called choroidal neovascularization cnv 2, 3. An rap lesion is frequently difficult to identify on fa, whereas icga can light up the choroidal circulation for easier identification of this subtype lesion type. Baltat z i s department of ophthalmology, medical school of athens university, athens gre e c e introduction retinal angiomatous proliferation rap is a distinct s u b g r oup of wet agerelated macular degeneration. Tomographic features of intraretinal neovascularization in retinal angiomatous proliferation. This form of neovascular armd, termed retinal angiomatous proliferation rap in this. Current treatment options for retinal angiomatous proliferans. One of the characteristics of rap, which distinguishes it from other types of exudative amd, is the rela. Visual acuity va, fluorescein angiography and optical coherence. Rap is now thought to account for 12%15% of newly diagnosed patients with namd. Original article treatment of bilateral retinal angiomatous. Pdf retinal angiomatous proliferation researchgate.
Treatment of retinal angiomatous proliferation in agerelated macular. Successful treatment of retinal angiomatous proliferation. Retinal angiomatous proliferation rap is a subtype of exudative agerelated macular degeneration amd that is characterized by retinaretinal or retinalchoroidal anastomosis 1. Histopathologic features from serial sections through the globe of a 93yearold man with agerelated macular. Three eyes had stage ii with rpe detachment, six had stage iii. Retinal angiomatous proliferation rap refers to a neovascular form of agerelated macular degeneration armd originating from the inner retinal vasculature. Retinal angiomatous proliferation rap, a subtype of neovascular amd, has been identified as a more aggressive type of cnv. To describe histopathologic features of an eye with retinal angiomatous proliferation rap secondary to agerelated macular degeneration treated with serial ranibizumab injections and to correlate these findings with spectral domain optical coherence tomography. The objective of the study was to investigate whether combined treatment with photodynamic therapy pdt and triamcinolone acetonide intravitreally applied is superior to pdt alone in eyes with retinal angiomatous proliferation rap.
Intravitreal bevacizumab avastin for retinal angiomatous proliferation. Retinal angiomatous proliferation is a distinct form of neovascular armd, and the term rap was coined by yannuzzi et al 3 in 2001. Realworld outcomes of antivegf treatment for neovascular agerelated. Treatment of retinal angiomatous proliferation lesions. Surgeons discuss advances in corneal transplant techniques and the future direction of treatment. Retinal angiomatous proliferation in agerelated macular. In this stage, there is usually a nodular mass of angiomatous tissue in the middle and inner retina. This is extremely common in the end stage of disciform disease.
Retinal angiomatous proliferation rap is defined as a variant of exudative age related macular degeneration amd in which the retinalchoroidal neovascularization is characterized by intraretinal capillary proliferation or, if the origin of the process is in the choroid, then it is an early retinalchoroidal. Retinal angiomatous proliferation rap is a unique variant of neovascular agerelated macular degeneration namd. Our pdf merger allows you to quickly combine multiple pdf files into one single pdf document, in just a few clicks. The role of dynamic indocyanine green angiography in the diagnosis and treatment of retinal angiomatous proliferation. Soque, cra octc coa on sep 24, 2012 rating 1 rating appears in retinal angiomatous proliferation conditionkeywords retinal angiomatous proliferation rap, subretinal neovascularization srnv, leakage, fundus autofluorescence faf, agerelated macular degeneration amd. Pdf merger, combine pdf files into one file online. Describe the approach to establishing the diagnosis. Define the relevant aspects of epidemiology of the disease. To evaluate focal pulsed laser treatment as the primary therapy for inner rap lesions associated with peds defined by video icga and fluorescein. Retinal angiomatous proliferation rap is a form of retinal choroidal neovascularisation within the wet agerelated macular degeneration amd category, characterised by intraretinal capillary proliferation, subretinal neovascularisation and a serousvascularised pigment epithelial detachment including a retinal choroidal anastomosis. Monitoring treatment of retinal angiomatous proliferation by.
Control c57bl6j mice were purchased from harlan laboratories blackthorn, uk. Retinal angiomatous proliferation rap is a form of retinalchoroidal neovascularisation within the wet agerelated macular degeneration amd category, characterised by intraretinal capillary proliferation, subretinal neovascularisation and a serousvascularised pigment epithelial detachment including a retinalchoroidal anastomosis. Retinal angiomatous proliferation associated with risk. Photodynamic therapy in retinal angiomatous p r oliferation. Published studies have estimated that up to 15% of patients with namd have rap. Retinal angiomatous proliferation or retinal anastomosis to the lesion. To describe two cases of retinal angiomatous proliferation raplike lesion following radiation therapy for primary tumor. Yannuzzi et al, coined the term retinal angiomatous proliferation rap, emphasizing upon the retinal origin of these lesions and proposed a three stage development.
Neovascular membranes obtained from surgical excision of neovascularization for retinal angiomatous proliferation rap were examined histopathologically in an attempt to elucidate the pathogenic mechanism of rap. Pdf merge combine pdf files free tool to merge pdf online. Nonproliferative retinopathy definition of nonproliferative. Clinicopathologic correlation of retinal angiomatous proliferation. Multiple names have been used to describe this entity. To describe histopathologic features of an eye with retinal angiomatous proliferation rap secondary to agerelated macular degeneration treated with serial ranibizumab injections and to correlate these findings with. Published studies have estimated that up to 15% of patients with neovascular agerelated macular degeneration have rap. However, this subtype is often excluded from clinical trials aimed at assessing the efficacy of various treatment options for nvamd. In recent years, the reverse also seems to be possible, as angiomatous proliferation originates from the retina and extends posteriorly into the subretinal space, eventually communicating in some cases with choroidal new vessels. Define the relevant aspects of epidemiology of the disease 1. Age is the strongest risk factor for development and progression of all forms of amd.
Treatment of retinal angiomatous proliferation in agerelated macular degeneration. Easily combine multiple files into one pdf document. Outcomes in eyes with retinal angiomatous proliferation in the comparison of agerelated macular degeneration treatments trials catt. Case 83 diagnosis retinal angiomatous proliferation. The role of optical coherence tomography oct in the.
Clinical features frequently associated with rap include bilateral disease, presence of pigment epithelial. Soda pdf merge tool allows you to combine pdf files in seconds. Retinal angiomatous proliferation in agerelated macular degeneration. The mode of transmission is autosomal dominant, often with incomplete penetrance and variable expression. Pdf angiographic and oct features of retinal angiomatous. Aug 21, 2009 konstantinidis l, mameletzi e, mantel i, pournaras ja, zografos l, ambresin a 2009 intravitreal ranibizumab lucentisr in the treatment of retinal angiomatous proliferation rap.
Experimental treatments such as the use of pdt combined with intravitreal triamcinolone injection demonstrate potential success with this entity. Polypoidal choroidal vasculopathy in caucasian patients with presumed neovascular agerelated macular degeneration and poor ranibizumab response. Retinal physician where do pcv and rap fit in the spectrum. Addressing corneal surface aberrations is taking refractive results to a new level. Objective to report the management of retinal angiomatous proliferation rap, a recently described intraretinal neovascular lesion occurring in agerelated macular degeneration. Capillary proliferation within the retina, originating from the deep capillary plexus in the paramacular area, is the earliest manifestation detected in any patient with rap. Select or drag your files, then click the merge button to download your document into one pdf file. Monitoring treatment of retinal angiomatous proliferation. Clinicopathological findings of retinal angiomatous.
Classification of retinal pigment epithelial detachments associated with drusen. Photodynamic therapy in retinal angiomatous p r oliferation stage i d. The eye diseases prevalence research group pooled data from seven regional populationbased studies and applied the rates to the 2000 united states census friedman et al. To demonstrate that retinal angiomatous proliferation rap lesions associated with pigment epithelial detachments ped can be diagnosed with indocyanine green angiography icga video angiography.
Clinical characteristics and current treatment of age. Polypoidal choroidal vasculopathy in caucasian patients. Rap represents the development and formation of a distinctive shunt vasculature originating from the outer retina potentially communicating with. Retinal angiomatous proliferation rap accounts for 1215% of all patients with neovascular agerelated macular degeneration nvamd. Retinal angiomatous proliferation rap is defined as a variant of exudative age related macular degeneration amd in which the retinal choroidal neovascularization is characterized by intraretinal capillary proliferation or, if the origin of the process is in the choroid, then it is an early retinal choroidal. Retinal angiomatous proliferation and intravitreal. Rapidly progressive scar formation after transpupillary thermotherapy in retinal angiomatous proliferation. In contrast to most conventional imaging techniques, doppler oct is able to provide depthresolved information about intra and transretinal blood flow noninvasively. Prevalence of retinal angiomatous proliferation in exudative age related macular degeneration within a retinal practice. Several devices and drugs are expected to come to the marketplace in the next few years. Baltat z i s department of ophthalmology, medical school of athens university, athens gre e c e introduction retinal angiomatous proliferation rap is a distinct s u b g r oup of wet agerelated macular degeneration armd, being.
Describe the approach to establishing the diagnosis a. Borrillo jl, martididis a, federman jl, sivalingam a. Retinal angiomatous proliferation stage ii with pigment epithelial detachment in agerelated macular degeneration differential diagnosis stage i intraretinal neovascularization only. Review of retinal angiomatous proliferation or type 3 neovascularization. Angiomatous definition of angiomatous by the free dictionary. Optimal treatment of retinal angiomatous proliferation. Clinical use and research applications of heidelberg. Retinal angiomatous proliferation is a variant of neovascular amd with a distinct clinical appearance. Apelin is required for nonneovascular remodeling in the.
Retinal angiomatous proliferation rap is a distinct form of choroidal neovascularization which may complicate a wet age related macular degeneration amd. Treatment of retinal angiomatous proliferation in agerelated. Retinale angiomatose proliferationen home thieme connect. Ranibizumab for retinal angiomatous proliferation in.
Characteristic findings of optical coherence tomography in. Retinal angiomatosis has both a hereditary and a sporadic form. How to merge pdfs and combine pdf files adobe acrobat dc. Surgical management of retinal angiomatous proliferation. Retinal angiomatous proliferation associated with risk alleles of arms2htra1 gene polymorphisms in japanese patients yasuhiro ohkuma,1 takaaki hayashi,1 tsutomu sakai,1 akira watanabe,1 hisashi yamada,2 masakazu akahori,3 takeshi itabashi,3 takeshi iwata,3 toru noda,4 hiroshi tsuneoka11department of ophthalmology, 2department of molecular genetics, institute of dna. Rcs dystrophic and congenic rats were bred from an established inhouse colony. Retinal angiomatous proliferation rap is a unique variant of neovascular agerelated macular degeneration.
This free online tool allows to combine multiple pdf or image files into a single pdf document. Jul 04, 2017 capillary proliferation within the retina, originating from the deep capillary plexus in the paramacular area, is the earliest manifestation detected in any patient with rap. Thus, there are no established protocols for the management of rap. Graefes arch clin exp ophthalmol april 29 epub ahead of print, doi. Bottoni f, massacesi a, cigada m, viola f, musicco i, staurenghi g.
Clinicopathologic correlation of retinal angiomatous. An oct scan obtained immediately after icgguided laser photocoagulation reveals a diffuse increase in intraretinal reflectivity precluding the visualisation of the previously observed intraretinal lesion d, arrowhead. Retrospective evaluation of two patients with previous irradiation treatment for a pleomorphic adenoma of the lacrimal gland and a vocal cord carcinoma, respectively. The data obtained from traditional multimodal imaging, based on fluorescein angiography. Experimental treatments such as the use of pdt combined with intravitreal triamcinolone injection. Retinal angiomatous proliferation rap is a somewhat rare finding that can lead to a form of endstage, agerelated macular degeneration amd in response to chronic surrounding tissue ischemia. Evaluating retinal angiomatous proliferation with optical.
Sep 10, 20 retinal angiomatous proliferation rap refers to a neovascular form of agerelated macular degeneration armd originating from the inner retinal vasculature. Retinal angiomatous proliferation article pdf available in current drug targets 122. The term retinal angiomatous proliferation rap was first proposed by yannuzzi and colleagues 4 and referred to a distinct form of neovascular agerelated macular degeneration namd, whereby retinal capillary proliferation is associated with a telangiectatic response. Retinal angiomatous proliferation rap is a distinct form of neovascular agerelated macular degeneration, originating from the retinal vasculature. Retinal angiomatous proliferation is a distinct and quite frequent phenotype of amd, accounting for 815% of newly diagnosed cases.
1349 175 406 160 1006 872 34 580 1481 358 684 702 1571 564 744 245 290 1362 1546 783 181 436 296 676 1017 199 1248 1204 808 1182 619 830 496 848 501 1575 1272 1357 1172 440 324 2 637 969 205