title: Understanding indocyanine green angiography in polypoidal choroidal vasculopathy: the group experience with digital fundus photography and confocal scanning laser ophthalmoscopy.
abstract: OBJECTIVE
  To evaluate the angiographic features in using fundus camera-based versus confocal scanning laser ophthalmoscope (cSLO)-based indocyanine green angiography in differentiating polypoidal choroidal vasculopathy (PCV) from typical age-related macular degeneration.
  
  
  METHODS
  Sixty-five eyes of 44 patients with exudative maculopathy due to PCV or typical age-related macular degeneration were prospectively imaged with indocyanine green angiography using fundus camera and cSLO. Images were graded independently by retinal specialists. The main outcome measure was agreement between cSLO and fundus camera for the diagnosis of PCV. The rate of detection and area under the receiver operating characteristic curve of 7 preselected individual features were also compared.
  
  
  RESULTS
  The diagnosis of PCV was made with the cSLO system in 36 eyes (55.4%) and typical age-related macular degeneration in 29 eyes (44.6%), whereas the fundus camera diagnosed PCV in 39 eyes (60.0%) and typical age-related macular degeneration in 26 eyes (40.0%). There was moderate agreement between the two indocyanine green angiography systems (Kappa = 0.53). Using cSLO as the gold standard, fundus camera has a sensitivity and specificity of 83.3% and 69.0%, respectively. Typical nodular appearance was the most commonly detected feature (median, 88.9% for cSLO, 80.6% for fundus camera, P = 0.63) and had the highest area under the curve for the diagnosis of PCV in both systems (median, 80.2% for cSLO, 73.2% for fundus camera, P = 0.13). Confocal scanning laser ophthalmoscope was more sensitive in detecting branching vascular network and late hyperfluorescent plaque.
  
  
  CONCLUSIONS
  Both systems detected >80% of PCV based on typical nodular appearance of polyps. However, the cSLO is superior in detecting additional features, particularly branching vascular network.
authors: *Singapore National Eye Centre, Singapore, Singapore; †Singapore Eye Research Institute, Singapore, Singapore; ‡Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; §Eye Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore; ¶Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; **Department of Ophthalmology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan; ††Oxford Eye Hospital, Oxford, United Kingdom; ‡‡Department of Ophthalmology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea; and §§Department of Ophthalmology, Nagoya City University, Nagoya, Japan.
authors: Chui Ming Gemmy
authors: CM
authors: Cheung
authors: Timothy Y Y
authors: TY
authors: Lai
authors: Shih-Jen
authors: SJ
authors: Chen
authors: Victor
authors: V
authors: Chong
authors: Won Ki
authors: WK
authors: Lee
authors: Hla
authors: H
authors: Htoon
authors: Wei Yan
authors: WY
authors: Ng
authors: Yuichiro
authors: Y
authors: Ogura
authors: Tien Yin
authors: TY
authors: Wong
mesh_terms: D000368:Aged; D019540:Area Under Curve; D020256:Choroidal Neovascularization / Q000175:diagnosis*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000175:diagnosis*; D008297:Male; D018613:Microscopy, Confocal; D009887:Ophthalmoscopy; D010781:Photography; D011127:Polyps / Q000175:diagnosis*; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green