The Role of Optical Coherence Tomography (OCT) in the Diagnosis and Management of Retinal Angiomatous Proliferation (RAP) in Patients with Age-related Macular Degeneration

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Abstract
The aim of this review was to describe the use of optical coherence tomography (OCT) in the diagnosis and management of retinal angiomatous proliferation (RAP) in patients with age-related macular degeneration (AMD). We reviewed the tomographic characteristics of the eyes affected by RAP seen at our institution and imaged by OCT. Some eyes with RAP were also studied with OCT prior to and after laser treatment to determine the tomographic changes following laser photocoagulation. In this preliminary report, OCT showed a typical pattern of structural changes in RAP: increased foveal thickness, cystoid macular oedema (CME) consisting of large central cysts and smaller cystoid spaces located mainly in the outer retinal layers, serous retinal detachment and a highly reflective intraretinal mass overlying a highly or moderately elevated retinal pigment epithelium (RPE). This mass corresponded to the hot spot observed on ICG angiography. After successful laser photocoagulation, significant decrease in foveal thickness, complete resolution of CME and retinal detachment with thinning of the neurosensory retina overlying the treated area could be observed. OCT appears to be useful in evaluating and documenting RAP in AMD patients both before and after laser photocoagulation. Longitudinal studies are required to determine its exact place and utility in clinical practice.