High resolution Fourier-domain optical coherence tomography of retinal angiomatous proliferation.
OBJECTIVE
To study the anatomic details of retinal angiomatous proliferation (RAP) in patients with age-related macular degeneration (AMD) using high-resolution Fourier-domain optical coherence tomography (Fd-OCT) and its three-dimensional reconstructions.


METHODS
A Fd-OCT instrument was used to image five patients clinically diagnosed with RAP. A series of 100 raster-scanned B-scans centered over the macula was registered and rendered as a three-dimensional volume. These retinal structures were analyzed for anatomic details of the RAP lesions.


RESULTS
The RAP lesion could be identified within the retina on Fd-OCT in all five cases. Fd-OCT images of the first four cases revealed areas of intraretinal neovascularization (IRN) in the deep retina adjacent to a pigment epithelial detachment (PED). There was neovascular proliferation anteriorly and posteriorly through a break in the retinal pigment epithelium (RPE). In three of the four cases, Bruch membrane remained intact. There was no identifiable choroidal neovascularization (CNV). The fifth case had both subretinal and sub-RPE neovascular membranes without a PED.


CONCLUSIONS
Fd-OCT provides unprecedented in vivo detail of the anatomy of RAP lesions that nearly resembles histologic specimens. This study suggests that the initial neovascular process in RAP can originate either within the retina or in the sub-RPE space.
Truong
Steven N
SN
Department of Ophthalmology and Vision Science, University of California, Davis Medical Center, USA.
Alam
Suhail
S
Zawadzki
Robert J
RJ
Choi
Stacey S
SS
Telander
David G
DG
Park
Susanna S
SS
Werner
John S
JS
Morse
Lawrence S
LS
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D005583:Fourier Analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology; D012160:Retina / Q000473:pathology; D015861:Retinal Neovascularization / Q000175:diagnosis* / Q000209:etiology; D041623:Tomography, Optical Coherence / Q000379:methods*