Advances in the treatment of retinal angiomatous proliferation

Retinal angiomatous proliferation(RAP), also known as “type 3 neovascularization”, is a well-recognized variation of neovascular age-related macular degeneration(nARMD). Neovascularization is the basic pathological characteristic. Current view on the origin of the neovascularization is the deep retinal capillaries. The main clinical features include retinal pigment epithelium detachment(PED)and reticular pseudodrusen. These two features have close relation to the retinal pigment epithelium(RPE)tear and geographic atrophy(GA), respectively, which may ultimately result in severe irreversible visual impairment. The disease has a rapid natural course and the majority of patients in early stage can develop into vision loss within 6mo. However, classical therapeutic managements, such as laser therapy, have limited efficacy and poor prognosis. Recently, RAP has been further understood with the application of OCT angiography and other new technologies in diagnosing, staging and monitoring RAP. Varieties of research on intravitreal injection of anti-vascular endothelial growth factor(VEGF)treatment to RAP have also revealed its promising results and proved its safety as well as effectiveness. All these have provided new knowledge on choosing the optimal treatment regimen in clinical.