Clinicopathologic correlation of retinal angiomatous proliferation.
OBJECTIVE
To correlate clinical and histopathologic features of an eye with retinal angiomatous proliferation (RAP) secondary to age-related macular degeneration and to investigate the expression of von Willebrand factor (VWF) and vascular endothelial growth factor (VEGF) in this condition.


METHODS
Histopathologic features from serial sections through the globe of an 87-year-old woman with RAP were studied and compared with fluorescein angiography and color fundus photographs obtained 4 months before death. Commercially available anti bodies were used to detect expression of VWF and VEGF in tissue sections.


RESULTS
The pathologic correlate of RAP was a circumscribed intraretinal angiomatous complex within the outer part of the neurosensory retina overlying a large pigment epithelial detachment. There were no breaks in the Bruch membrane. No choroidal neovascularization was present. Endothelial cells within the RAP lesion immunostained positively for VWF and VEGF. The Bruch membrane expressed VWF adjacent to the RAP.


CONCLUSIONS
Fundus examination and fluorescein angiography images of RAP in a patient with age-related macular degeneration correlated histopathologically with a neovascular intraretinal angiomatous complex, without the presence of sub-retinal pigment epithelial neovascularization. Immunostaining demonstrated that RAP expresses VWF and VEGF.
Monson
Dinelli M
DM
Casey Eye Institute, Portland, OR 97239-4197, USA.
Smith
Justine R
JR
Klein
Michael L
ML
Wilson
David J
DJ
D000369:Aged, 80 and over; D000798:Angiomatosis / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D016570:Bruch Membrane / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007150:Immunohistochemistry; D008268:Macular Degeneration / Q000150:complications; D010781:Photography; D015861:Retinal Neovascularization / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D014841:von Willebrand Factor / Q000378:metabolism
C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D014841:von Willebrand Factor