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A.F. Cruess, C. Howitt, J. Bakal, S. Sharma; ICG Angiography as a Guide to Visudyne Therapy for Subfoveal Choroidal Neovascularization (CNV) in AMD . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1809.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: to study the diagnostic benefit of late phase plaque hyperfluorescence on indocyanine green angiography (ICG) as a method of identifying greatest linear diameter (GLD) for Visudyne treatment of subfoveal CNV Methods: Thirty consecutive patients presenting with subfoveal CNV were evaluated with simultaneous ICG and fluorescein angiography (FA) using the Heidelberg Retinal Angiograph (HRA), a laser ophthalmoscope based system. Plaque hyperfluorescence (unenhanced) was studied in the late phase of the ICG component of each angiographic study and traced using the image software of the HRA. In addition the GLD of each lesion was measured. The late phase ICG- determined plaque hyperfluorescence, known to correlate with CNV pathologically (Chang, T. et al. RETINA 1994; 14:130-42), was then used to overlay the FA in the mid phase of the angiogram. In addition, in a masked ("blinded") fashion, the area of the lesion to be treated and its GLD were measured in the mid-phase of the FA by a single observer (AFC). Results: In all cases, the plaque lesion on ICG as imaged on the HRA system corrlelated highly with the area and GLD of the fluorescein lesions measured in the mid phase of the FA using HRA software. Conclusions: The ICG remains highly undervalued as an important diagnostic tool in the treatment planning of subfoveal CNV with Visudyne. Indeed, this study raises the question as to whether ICG may be less fraught with problems of interpretation than the current clasification system of subfoveal CNV by fluorescein angiography alone, especially when obtained via sinultaneous FA/ICG methodology.
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