Purpose: To report an unusual phenotype of retinal angiomatous proliferation ( RAP) in age-related macular degeneration (AMD) and its short-term response to laser photocoagulation. Methods: Case report. Results: An 85-year-old woman wa s found to have an unusual RAP with a major feeder vessel originating from a cil ioretinal artery and associated with a cilioretinal-retinal anastomosis (C-RRA ). Diffuse cystoid macular edema (CME), intraretinal hard exudates in a circinat e pattern, and a fibrovascular pigment epithelial detachment (PED) were present. Laser photocoagulation was performed and led to occlusion of the cilioretinal f eeder vessel and angiomatous lesion, with less CME. The other (retinal) arm of t he C-RRA became more engorged and a new cilioretinal feeder developed, and both were associated with intraretinal hemorrhages. Visual acuity was stable and the PED persisted throughout follow-up. Conclusions: We report an unusual phenotyp e of RAP that is associated with a major cilioretinal feeder vessel and comment on the possible effect of such an association on the response to laser treatment .
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