Issue 6/2022
Сh. Vidinova, D. Antonova
Department of “Eye Diseases, Ear, throat
and nose diseases and oral surgery”,
Military Medical Academy – Sofia
Retinal angiomatous proliferations (RAP) are one rare exudative maculopathy, occurring only in 10% of all cases of Age related macular degeneration (AMD).
Objective: The aim of our survey is to describe a rare clinical case of RAP with bilateral affection and discuss the diagnostical methods and possible clinical therapies. Material and methods: We present a case of a 73 year old patient with bilateral occurrence of RAP examined and followed at Eye Clinic Military Medical Academy, Sofia. He underwent a complete ophthalmologic examination, including visual acuity, Amsler test and fluorescein angiography. Optical coherence tomography (OCT) was also done with the spectral OCT device RTVue OPTOVUE. The retinal standard programs – HD Line, 3 D Macular Test and MM5 quantitative retinal assessment tests have been used. Results: The Visual acuity of the patient on his firs visit was 20/10 for the right eye, and 20/50 for the left eye, with drusen and significant edema in the posterior pole. On the fluorecein angiographic pictures intraretinal proliferations were found in the left eye and retino-choroidal anstomoses in the right one. The ОСТ examination confirmed the diagnosis of RAP and enabled us to establish the stage of the disease. In the left eye the intraretinal proliferations did not involve the subretinal space, so this was RAP I. While in the right eye connections between the retinal and choroidal vessels were seen, as well as serous detachment of the RPE- RAP stage III. We used anti-VEGF therapy in the right eye. Conclusion: Retinal angiomatous proliferations represent an exudative maculopathy, with specific FA and OCT characteristics, differing it from the typical age related macular degeneration. Precise diagnosis and stages of the disease are possible to establish only with the help of optical coherence tomography. RAP is an illness, which due to its specific pathogenesis, clinical picture and bilateral affection has to be carefully diagnosed and monitoring of both eyes has to be taken in consideration.
Address for correspondence:
H. Vidinova, Clinic of Ophthalmology,
Military Medical Academy
3, “Georgy Sofiisky” Str.
1606 Sofia, Bulgaria
Tel: +359 2 922 53 21; Fax: +3592 952 65 36
Mobile: +359 888 38 75 29
e-mail: christinavidinova@yahoo.com