Indocyanine green angiography in age-related macular degeneration with occult neovascularization.
This study has been conducted to assess the sensitivity of indocyanine green angiography (ICGA) in detecting choroidal neovascularization (CNV) in patients with age-related macular degeneration (ARMD) with occult CNV at fluorescein angiography (FA) and to establish their eligibility for laser photocoagulation. Three hundred eighty-three eyes of 355 consecutive patients with occult CNV at FA were studied by ICGA; occult CNV with or without pigment epithelial detachment (PED) were detected as well. Eligibility for laser treatment was established on the basis of the ICGA-guided CNV extension and localization. Out of 157 eyes (41%) with occult CNV and PED, 74 (47.1%) showed focal ICGA CNV, 35 eyes (22.3%) had plaque CNV. Thirty-five eyes with PED (22.3%) appeared serous without CNV, and in 13 eyes (8.3%) no CNV was detectable because of large hemorrhages. Out of the 226 eyes (59%) presenting occult CNV without PED, 94 eyes (41.6%) had plaque CNV, and 58 (25.7%) had focal CNV. In 74 eyes (32.7%), there was no detectable CNV or only an ill-defined ICGA appearance. ARMD with PED is closely associated with focal CNV, while plaque CNV is largely found in exudative ARMD without PED (p < 0.001). Considering all the cases examined by ICGA, CNV was evident in 261 eyes (68%) occult at FA. Extrafoveal CNV laser treatment was recommended for 103 eyes (27%). Our results suggest that ICGA may be useful in the diagnosis and management of ARMD with occult CNV at FA increasing the number of patients eligible for laser treatment.
Pece
A
A
Department of Ophthalmology and Visual Sciences, Scientific Institute, S. Raffaele Hospital, University of Milano, Italy.
Introini
U
U
Bolognesi
G
G
Brancato
R
R
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D003657:Decision Making; D005260:Female; D005451:Fluorescein Angiography; D005456:Fluorescent Dyes; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D010857:Pigment Epithelium of Eye / Q000473:pathology / Q000601:surgery; D012163:Retinal Detachment / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D005456:Fluorescent Dyes; D007208:Indocyanine Green