RAP Retinal angiomatous proliferation Edi LadavacGeneral Hospital Pula.

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Presentation transcript:

RAP Retinal angiomatous proliferation Edi LadavacGeneral Hospital Pula

Drusen Atrophic type Exudative form AMD

Exudative AMD CNV Disciform scar Choroidal-retinal anastomosis

Exudative AMD = CNV ? ? ?

Exudative AMD Yannuzzi (2001) 1.choroidal neovascularisation ( CNV) 2.retinal angiomatous proliferation (RAP) 3.polypoidal choroidal neovascularisation NEW !

RAP White patientsWhite patients bilateralbilateral Dg. FAG + ICGA + OCTDg. FAG + ICGA + OCT therapytherapy

RAP – clinical picture IRN Stage I - IRN (intraretinal neovascularisation) SRN Stage II - SRN (subretinal neovascularisation) CNV Stage III - CNV (choriodal neovascularisation)

RAP – stage I Intraretinal angiomatous proliferationIntraretinal angiomatous proliferation RRA (retinal-retinal anastomosis)RRA (retinal-retinal anastomosis) HemorrhagesHemorrhages

RAP – stage II elevation retinal elevation reaction of the RPEa reaction of the RPEa PED PED

RAP stage III Choroidal neovascularisation (CNV)Choroidal neovascularisation (CNV) Retinal-choroidal anastomosis (RCA)Retinal-choroidal anastomosis (RCA)

RAP- diagnosis Biomicroscopic examinationBiomicroscopic examination FAGFAG ICGAICGA OCTOCT

RAP – case report Small hemorrhagesSmall hemorrhages Case I Case II

RAP –case report Feeding arteriole (dilated vessels)Feeding arteriole (dilated vessels) Case I Case II

RAP - case report Retinal oedemaRetinal oedema PEDPED Case I Case II

RAP – case report ICG angiographyICG angiography Case I Case II Trieste – Padova 2004

RAP - therapy 1.PDT + triamcinolone intravitreal 2.VEGF inhibitors (Macugen) intravitreal 3.Macular surgery 4.Laser

RAP - therapy Triamcinolone + PDTTriamcinolone + PDT Before th After th Trieste OCT

RAP - conclusion CNV AMD RAP PCN Exudative form

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