Good Hope, Heartlands, and Solihull Eye Clinics

Retinal angiomatous proliferation: 'Rap', type 3 wet Age Related Macular Degeneration (ARMD)

David Kinshuck

Retinal angiomatous proliferation: 'RAP', type 3 CNV

type 1 cnv

type 3 CNV, a rap: the choroidal vessels and retinal vessels join up (anastamose)

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

  • text    multifocal Retina 20
  • 25% good response Retina17
  • mean timme of recurrence was 5 months after the 3rd injection Retina17
  • 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"
  • During treatment 5% of patients developl submacular haemorhages, and 5% rips  Retina18

a dome is shown on the OCT...fluid, enlarge, and there is exudate and a small haemorrhage enlarge.