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.
Department of Ophthalmology and Visual Sciences, Scientific Institute, S. Raffaele Hospital, University of Milano, Italy.
A
A
Pece
U
U
Introini
G
G
Bolognesi
R
R
Brancato
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