Abstract
Purpose: :
Infrared autofluorescence (IR-AF) is mainly originated from melanin in the retinal pigment epithelium (RPE) or the choroid. IR-AF can evaluate changes of the RPE in various macular diseases. However, little is known about IR-AF findings in idiopathic choroidal neovascularization. We investigated IR-AF patterns and related changes in patients with idiopathic choroidal neovascularization treated with intravitreal bevacizumab (IVB).
Methods: :
A retrospective observational consecutive case series. Bevacizumab was intravitreally injected into 12 eyes of 12 patients with idiopathic choroidal neovascularization as the primary treatment. Color fundus photographs, optical coherence tomography (OCT), fluorescein angiography and indocyanine green angiography, autofluorescence imaging (SW-AF: short wave-length autofluorescence, IR-AF) were performed for the baseline examination. Changes in the autofluorescence pattern were evaluated after IVB.
Results: :
All 12 eyes showed classic choroidal neovascularization on fluorescein angiography at baseline. OCT showed CNV above the RPE in all eyes. After treatment, best corrected visual acuity (BCVA) improved compared to baseline BCVA (P < .001). IR-AF demonstrated the ring-shaped hyperautofluorescence surrounding choroidal neovascularization corresponding to the dark rim on indocyanine green angiography. Six of 12 eyes showed ring-shaped hyperautofluorescence on IR-AF at baseline. During the follow-up period after IVB, all 12 eyes showed ring-shaped hyperautofluorescence. The intensity of ring-shaped autofluorescence and its contrast increased in the regression phase of choroidal neovascularization. The contrast of ring-shaped autofluorescence partially decreased in all 3 eyes with recurrence.
Conclusions: :
Ring-shaped hyperautofluorescence on IR-AF in the eyes with ICNV images may indicate involutional process of choroidal neovascularization enveloped by the RPE because its area corresponded to the dark rim of indocyanine green angiography that reflect regression of idiopathic choroidal neovascularization. IR-AF can be useful as an adjunctive examination, since it can be used to evaluate the involution of choroidal neovascularization non-invasively.
Keywords: choroid: neovascularization • retinal pigment epithelium • vascular endothelial growth factor