Good Hope Eye Clinic

Type 3 neovascularization (retinal angiomatous proliferation): 'Rap', a type of wet Age Related Macular Degeneration (ARMD)

David Kinshuck

type 3 neovascularization (retinal angiomatous proliferation): 'RAP'

A RAP (retinal angiomatous proliferation) is a type of wet ARMD. It does not respond as well to antiVEGF treatment as the other types.

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  • Eye 2010
  • Eye 15
  • Retina 16 OCT  "subfoveal choroidal thickness <200 μm, presence of intraretinal fluid accumulation, absence of subretinal fluid, gently-sloping dome-shaped retinal pigment epithelial detachment or trapezoid-shaped retinal pigment epithelial detachment without an obvious peak, and intraretinal mass lesion"
  • beginning with    Retina15   "the earliest sign of Type 3 neovascularization is punctate hyperreflective foci above the external limiting membrane. The mature Type 3 lesions and associated serous pigment epithelial detachments are highly responsive to anti-vascular endothelial growth factor therapy"
  • "Baseline fundoscopic features of the fellow eye differ significantly between retinal angiomatous proliferation and typical exudative age-related macular degeneration. A large area (>510,196 μm2) of soft drusen in the central 6,000 μm confers a significantly higher risk of neovascularization and should be considered as a phenotypic risk factor."    Retina 15

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a dome is shown on the OCT...fluid

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there is exudate and a small haemorrhage enlarge