Abstract
Abstract: :
Purpose: To determine the true prevalence of retinal angiomatous proliferations (RAP) in mixed lesions (minimally classic or occult choroidal neovascualrization {CNV}) in age–related macular degeneration (ARMD)> Methods: Patients originally imaged with digital intravenous fluorescein angiography to investigate for treatable choroidal neovascularization in ARMD who demonstrated occult or minimally classic choroidal neovascular lesions were studied with simultaneous fluorescein (FA) / indocyanine green angiography (ICG) using the Heidelberg Retinal Angiograph (HRA II). Simultaneous fluorescein/ICG angiographic images were captured at 9 frames per second in a resolution of 768 X 768 pixels in a scan size of 30 degrees with a scan depth of 3 mm and a scale of 0.10823 pixel/mm. Using the movie mode as well as a frame by frame analysis of the simultaneous FA and ICG images, the first author independently confirmed the presence of and location of the choroidal retinal anastomosis. > Results: From a consecutive series of 21 patients, 10 (47%) were found to have lesions with an apparent RAP component and 2 separate cases were found within the same series to have polypoidal choroidal vasculopathy (PCV). This is a higher percentage of RAP than has been previously reported in similar series. The ICG was particularly useful in detecting RAP, especially when correlated frame by frame with the fluorescein as will be illustrated. In two cases, an alternating reversal of choroidal blood flow or a "choroidal steal" phenomenon was observed in the dynamic ICG commponent of the angiographic study Conclusions: These results indicate that our understanding of choroidal neovascularization in ARMD continues to evolve as a result of clinical findings correlated with laser scanning ophthalmoscopic angiographic imaging technologies, specifically by dynamic simultaneous imaging of CNVM using fluorescein and ICG dyes..
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: systems/equipment/techniques • choroid: neovascularization