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Franck Lalloum, Nicolas Leveziel, Giuseppe Querques, Oudy Semoun, Nathalie Puche, Jennyfer Zerbib, Julien Tilleul, Eric H Souied; INDOCYANINE GREEN ANGIOGRAPHY FOR TYPE 1 CHOROIDAL NEOVASCULARIZATION IN AMD. Invest. Ophthalmol. Vis. Sci. 2014;55(13):664.
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Fluorescein angiography (FA) is a major tool for the phenotypic classification of exudative age macular degeneration (AMD) and optical coherent tomography (OCT) is a major tool for monitoring the treatment and the follow-up of exudative AMD patients. The purpose of our study was to analyze the contribution of indocyanine green angiography (ICGA) in addition to FA in the diagnosis of occult (type 1) choroidal neovascularization (CNV).
A total of 103 eyes of 96 treatment-naive patients affected with occult choroidal neovascularization related to AMD were prospectively included. Diagnosis of occult CNV was established on the basis of FA. A complete ophthalmologic examination was performed, including FA, OCT and confocal ICGA (Spectralis, Heidelberg, Germany).
Mean age was 77.7±7.63 (range 55-96) , sex ratio was 32/64 (males/females). After ICGA examination, occult CNV could be classified in four morphologic types of CNV : “small membrane” , CNV less than an optic disk diameter in size (8/103; 7.8%), hot spot (26/103; 25.2%), “large plaque” (67/103; 65%), or polypoidal choroidal vasculopathy (2/103; 2%). Interestingly, 37% (3/8) of “small membrane”, 31% (8/26) of hot spots and the 2 patients with polypoidal choroidal vasculopathy harbored lesions located over 1000µm of the foveola and potentially eligible for laser treatment (13/103; 12.6%).
In our study ICGA allowed to classify FA-detected CNV in 4 groups. Current findings support the idea that ICGA is useful in the evaluation and classification of patients diagnosed as occult CNV in AMD. Laser photocoagulation could be performed on the basis of ICGA examination in a limited number of cases.
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