Multi-imaging distinguishes choroidal neovascularization types
The cross-sectional retrospective study singled out retinal angiomatous proliferation (RAP), a particularly aggressive lesion type, in a group of AMD patients by using the multi-imaging approach.
At Luigi Sacco Hospital Eye Clinic at the University of Milan, Italy, researchers studied images of one eye in each of 30 patients with neovascular AMD. Each of the subjects was affected by active neovascular lesions, including occult type 1, classic type 2 and RAP type 3. Sixteen of the 30 cases were classified as RAP cases.
Corresponding study author Giovanni Staurenghi, MD, told Ocular Surgery News that the problems associated with choroidal neovascularization vary, from loss of visual acuity to low vision.
“In particular, RAP lesions are quite aggressive and have a high possibility of involving both eyes in a shorter [period of time],” he said.
Using the images, the authors looked for characteristics found more often in RAP lesions than in other types. Fluorescein angiography showed shunting of blood flow to the lesions; indocyanine green angiography detected late leakage; spectral domain OCT showed both intraretinal cysts and retinal pigment epithelium interruption along the retinal pigment epithelium detachment; and infrared light showed pseudodrusen.
Shunting of blood flow to lesions was seen in 56% of eyes with RAP but in none of the other eyes. Late leakage was evident in all RAP cases and in 7% of the others. Intraretinal cysts were found in all RAP cases and in 14% of the others. Retinal pigment epithelium interruption was detected in 93% of RAP cases and 15% of the other types, and reticular pseudodrusen was found in 87% of RAP patients and 21% of the others.
Study limitations noted by the authors included the small sample size and the potential for bias because they used “selective nonconsecutive cases analyzed in a retrospective manner.”
Nonetheless, the authors maintained that multi-imaging helps differentiate lesion types…..