Indocyanine green hyperfluorescence associated with serous retinal pigment epithelial detachment in age-related macular degeneration.
OBJECTIVE
Indocyanine green (ICG) angiography may improve visualization of choroidal neovascularization (CNV) associated with serous retinal pigment epithelial detachment (RPED) in age-related macular degeneration (AMD). The features of ICG hyperfluorescence associated with serous RPED and therapeutic effect of ICG-directed laser photocoagulation in eyes with serous RPED is evaluated.


METHODS
Retrospective review of all simultaneous fluorescein/ICG angiograms (n = 918) performed over an 18-month period to identify 44 eyes in 39 patients with serous RPED secondary to AMD on fluorescein angiography.


METHODS
Thirty-nine patients with AMD, aged 53 to 89 years, participated.


METHODS
Eyes were nonrandomly treated with ICG-directed laser photocoagulation or observation.


METHODS
Characteristics of ICG hyperfluorescence associated with a serous RPED are reviewed. Final visual acuity and anatomic appearance of the serous RPED are given.


RESULTS
Twenty-three (52%) of the 44 eyes had an isolated serous RPED without obvious CNV, and 21 (48%) of the 44 eyes had a serous RPED associated with occult CNV on fluorescein angiography. Indocyanine green angiography demonstrated underlying CNV in 19 eyes (83%) with an isolated serous RPED and in all 21 eyes (100%) with serous RPED and occult CNV. The pattern of ICG hyperfluorescence revealed focal CNV in 15 eyes and plaque CNV in 4 eyes with an isolated serous RPED. In eyes with serous RPED and occult CNV, focal CNV and plaque CNV were noted with ICG in 8 and 13 eyes, respectively. No follow-up was available for two eyes. Twenty eyes were treated with ICG-directed laser photocoagulation. In these eyes, the visual acuity remained stable in 6 eyes (30%) and decreased in 14 eyes (70%). Twenty-two eyes were observed, and the visual acuity remained stable in 8 (36%), improved in 2 (9%), and decreased in 12 eyes (55%).


CONCLUSIONS
Although ICG angiography may enhance visualization of CNV associated with serous RPED in AMD, ICG-directed laser treatment did not appear to improve visual acuity when compared with observed eyes in this series.
Baumal
C R
CR
New England Eye Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
Reichel
E
E
Duker
J S
JS
Wong
J
J
Puliafito
C A
CA
D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D012163:Retinal Detachment / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green