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MD Somaiya, BM Glaser; High-Speed Phi-motion ICG Characteristics and Feeder Vessel Treatment of Polypoidal Choroidal Vasculopathy in Age-Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2509.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To study the dynamic vascular pattern of polypoidal choroidal vasculopathy (PCV) in a consecutive series of elderly multi-ethnic patients using High-speed, Phi-motion indocyanine-green angiography (HS-ICG). Methods: A consecutive series of 451 eyes of 335 multi-ethnic patients ranging in age from 52 to 98 were evaluated. All patients were diagnosed with exudative age-related macular degeneration. The choroidal neovascularization (CNV) was further characterized by fluorescein angiography (FA) and HS-ICG in all patients. Results: Ten of 451 (2.2%) consecutive eyes presenting with CNV and AMD were diagnosed with PCV via HS-ICG, static ICG and FA imaging. The PCV tended to occur in clusters with a total of 15 clusters in the 10 eyes evaluated. Of the 15 clusters of PCV, 9 (60%) had a subfoveal location, 4 (26.7%) were located in the macula with foveal sparing, and 2 (13.3%) were peripapillary. Feeder vessels (FV) were identified in 7 of the 10 PCV eyes. Five of the 7 FVs directly supplied the PCV. Regression of subretinal fluid, hemorrhage and lipid, with attenuation or resolution of the polypoid dilatations 6 months after FV treatment occurred in 6 of the 7 treated PCV eyes. A mean number of 4.6 treatments were required to obtain the reported results. Visual acuity at the last follow-up of 1.5 to 22 (mean = 13.5months) months following initial treatment remained within + 2 lines of pre-treatment vision in all eyes. Conclusion: HS-ICG is a useful tool for the identification and characterization of PCV as well as the identification of associated FVs. FV treatment can result in regression of the PCV lesions that are supplied directly by the FV. Interestingly, even in cases where the FV supplied a larger lesion containing PCV, treatment of the FV caused regression of the PCV. These findings provide a better understanding of the angio-architecture of PCV.
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