Our patient has age-related macular degeneration with a type 3 macular neovascularization (MNV), also known as retinal angiomatous proliferation (RAP).
Her fundus photo reveals inner retinal hemorrhages of her right eye and variable intraretinal fluid on OCT. Our patient showed no obvious exudation clinically, but the small amount of intraretinal fluid on OCT in the left eye indicates a subclinical RAP in this eye as well.
Bilateral anti-VEGF therapy was started, and we expect that she will do well.
Learning Points:
Unlike more typical age-related MNV that start either below (type 1 MNV) or occasionally above (type 2 MNV) the RPE, RAP lesions originate within the retina.
These incompetent vessels leak fluid and blood into the surrounding tissue.
