Abstract
Purpose: :
Pigment epithelial detachments associated with age–related macular degeneration can often harbor choroidal neovascular membranes, which can predispose to severe complications such as hemorrhagic pigment epithelial detachment. We evaluated the ability of dynamic indocyanine green angiography in allowing visualization of choroidal neovascularization not detectable by fluorescein angiography.
Methods: :
A consecutive series of thirty epithelial detachments in which fluorescein angiography failed to detect neovasculaization, or detected only ill–defined hyperfluorescence, were investigated by dynamic, high speed indocyanine green angiography. In seven cases, the choroidal neovascularization was treated with photodynamic therapy and intravitreal triamcinolone.
Results: :
Indocyanine green angiographic evidence of choroidal neovascularization was detected in twenty of thirty eyes. Four distinct patterns of choroidal neovascularization were identified, including well defined choroidal neovascularization restricted to the margin of the pigment epithelial detachment, well defined hyperfluorescence, diffuse subRPE neovascularization and polypoidal choroidal vasculopathy. Treatment of marginal neovascularization resulted in flattening of the pigment epithelial detachment in six of the seven cases.
Conclusions: :
Dynamic indocyanine green angiography can visualize marginal or diffuse choroidal neovascularization associated with pigment epithelial detachment in a significant number of eyes in which fluorscein angiography failed to confirm the presence of choroidal neovascularization. In some cases treatment may lead to flattening of the choroidal neovascularization.
Keywords: age-related macular degeneration • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • photodynamic therapy