Treatment Effects in Retinal Angiomatous Proliferation Imaged with OCT Angiography

Jan H de Jong, Boy Braaf, Sankha Amarakoon, Maximilian Gräfe, Suzanne Yzer, Koenraad A Vermeer, Tom Missotten, Johannes F de Boer, Mirjam E J van Velthoven

Research output: Contribution to journalArticleResearchpeer-review


PURPOSE: This prospective case series is aimed at exploring optical coherence tomographic angiography (OCT-A) as a treatment monitoring tool in patients treated for retinal angiomatous proliferation (RAP).

METHODS: Twelve treatment-naïve RAP patients were included, with a median age of 79 years (range 65-90). Patients were imaged with an experimental 1,040-nm swept-source phase-resolved OCT-A instrument before and after treatment. Treatment consisted of either intravitreal bevacizumab or triamcinolone injections with or without photodynamic therapy (PDT). Abnormal blood flow after treatment was graded as increased, unchanged, decreased, or resolved.

RESULTS: OCT-A images before and after treatment could be obtained in 9 patients. The median follow-up period was 10 weeks (range 5-19). After various treatments, the RAP lesion resolved in 7 patients, in 1 patient the OCT-A depicted decreased flow in the lesion, and 1 patient showed unchanged abnormal blood flow. Monotherapy with intravitreal bevacizumab injections resolved RAP in 1 out of 2 patients. Combined therapy of bevacizumab with PDT resolved RAP in 6 out of 7 patients.

CONCLUSIONS: OCT-A visualized resolution of abnormal blood flow in 7 out of 9 RAP patients after various short-term treatment sequences. OCT-A may become an important noninvasive monitoring tool for optimizing treatment strategies in RAP patients.

Original languageEnglish
Pages (from-to)143-153
Number of pages11
Issue number3
Publication statusPublished - 2019


  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors/administration & dosage
  • Bevacizumab/administration & dosage
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Fluorescein Angiography/methods
  • Follow-Up Studies
  • Fundus Oculi
  • Glucocorticoids/administration & dosage
  • Humans
  • Intravitreal Injections
  • Macular Degeneration/diagnosis
  • Male
  • Photochemotherapy/methods
  • Photosensitizing Agents/therapeutic use
  • Prospective Studies
  • Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors
  • Retina/pathology
  • Retinal Neovascularization/diagnosis
  • Tomography, Optical Coherence/methods
  • Treatment Outcome
  • Triamcinolone/administration & dosage
  • Visual Acuity


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