Indocyanine-green videoangiography of drusen as a possible predictive indicator of exudative maculopathy.
OBJECTIVE
Recent studies have shown that indocyanine-green videoangiography (ICG-V) is useful to image occult choroidal neovascularization. The authors studied the ICG-V findings in fellow drusen eyes of patients with unilateral exudative age-related macular degeneration (AMD). The authors also studied the occurrence of exudative changes to determine whether ICG-V is useful in predicting future exudative changes in these eyes with only drusen.


METHODS
Cohort study.


METHODS
The authors studied 432 consecutive patients diagnosed with unilateral exudative AMD in whom the fellow eye had only drusen by clinical fundus examination and fluorescein angiography. All of these eyes had ICG-V performed. Follow-up data were obtained in all eyes with abnormal indocyanine-green (ICG) angiograms and randomly sampled ICG angiograms of normal eyes.


METHODS
The initial ICG findings were classified as showing normal or abnormal hyperfluorescence. Abnormal hyperfluorescence eyes were subdivided into focal spots (focal areas of hyperfluorescence < 1 disc area in size) and plaques (areas of hyperfluorescence > 1 disc area). The development of exudative changes in eyes with normal and abnormal hyperfluorescence was compared.


RESULTS
Of the 432 fellow eyes, 386 (89%) eyes with drusen had a normal ICG-V study, whereas 46 (10 focal spots and 36 plaques) (11%) eyes had an abnormal ICG-V. Exudative changes occurred in 6 (10%) of 58 normal ICG eyes and 9 (24%) of 38 eyes with abnormal ICG findings during a mean follow-up period of 21.7 months. The difference between drusen eyes with normal ICG angiograms and those with plaques on ICG-V regarding future exudative changes (10% vs. 27%, respectively) was statistically significant (P = 0.038).


CONCLUSIONS
Abnormal ICG findings were found in 11% of eyes with clinically and fluorescein angiographically nonsuspicious drusen. The subgroup of patients with plaques on ICG-V had a higher chance of having exudative changes develop. Indocyanine-green videoangiography may be a predictive indicator of future exudative changes in eyes with drusen. A much larger prospective study seems justified.
Hanutsaha
P
P
Retinal Research Laboratory, Manhattan Eye, Ear & Throat Hospital, New York, New York 10021, USA.
Guyer
D R
DR
Yannuzzi
L A
LA
Naing
A
A
Slakter
J S
JS
Sorenson
J S
JS
Spaide
R F
RF
Freund
K B
KB
Feinsod
M
M
Orlock
D A
DA
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D005456:Fluorescent Dyes; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015593:Retinal Drusen / Q000175:diagnosis*; D014741:Video Recording
D005456:Fluorescent Dyes; D007208:Indocyanine Green