Retinal Angiomatous Proliferation: Multimodal Imaging Characteristics and Follow-up with Eye-Tracked Spectral Domain Optical Coherence Tomography of Precursor Lesions

Abstract

Objectives: To present the multimodal imaging characteristics of precursor retinal angiomatous proliferation(RAP) lesions and follow-up results with eye-tracked spectral-domain optical coherence tomography (SD-OCT).Materials and Methods: Six eyes of 6 patients aged 77.5±5.9 years diagnosed with precursor RAP lesion were included in this prospectiveobservational case series. Best corrected visual acuity (BCVA) measurement and complete ophthalmologic examination were performed forall subjects, as well as fundus photography (FP), fundus autofluorescence (FAF), SD-OCT, fluorescein angiography (FA), indocyaninegreen angiography (ICGA), optical coherence tomography angiography (OCTA), and their long-term follow-up results are presented.Results: The mean BCVA was 0.8±0.16 (0.6-1) Snellen and the mean follow-up was 26.3±14.8 months. Images ofthe precursor RAP lesions demonstrated no specific findings on FP and FAF, showed focal hypofluorescent foci with noleakage on FA and IGA, and appeared as extrafoveal small, round, well-defined, hyperreflective foci typically locatedin the outer retinal layers on SD-OCT B-scans with high sampling density. OCTA demonstrated the precursor lesionsas the deep capillary plexus abnormalities in 3 eyes. Two eyes progressed to stage 1 RAP during the follow-up period.Conclusion: This study defined the diagnostic characteristics and clinical course of precursor RAP lesions. Our findings highlight theimportance of B-scans with high sampling density for the diagnosis of precursor lesions and using eye-tracking mode SD-OCT duringfollow-up.