Evaluating Retinal Angiomatous Proliferation With Optical Coherence Tomography Angiography

BACKGROUND AND OBJECTIVE: To report the imaging features of different stages of retinal angiomatous proliferation (RAP) on optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Patients diagnosed with RAP were included in this study. All patients underwent fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and OCTA. The OCTA features were illustrated and compared with FA, ICGA, and OCT. OCTA was performed at baseline and after injection of anti-vascular endothelial growth factor (VEGF). RESULTS: A total of 12 eyes of 12 consecutive patients were included. Patients' ages ranged from 57 to 82 years. In all cases, the hot spot lesions found on FA or ICGA were clearly detected on OCTA in the same area (12/12, 100%). Hot spot lesions showed variable patterns. Four patients had multiple hot spot lesions located on the outer retina layer, deep layer, or superior retinal layer. OCTA showed a clearer location and relationship with feeder vessels compared with FA or ICGA. Eight patients had received anti-VEGF therapy 1.75 +/- 1.06 times. Follow-up OCTA images demonstrated smaller and fewer hot spot lesions with lesser blood flow signal. CONCLUSIONS: OCTA is a noninvasive, fast imag ing modality for detecting microvascular changes, and it provides more detail of the RAP lesion and related vessels than ICGA or FA. OCTA would be a valuable tool for follow-up observation. The OCTA patterns of RAP may be helpful in understanding its pathology.