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L Maestroni, M Ottochian, L Migliavacca, R Faletra, N Orzalesi; Reclassification of Occult Choroidal Neovascularization Due to Armd by High Dynamic Speed Indocyanine Green Angiography . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2495.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the definition of "manifest" and "occult" subfoveal neovascularization based upon fluorescein angiography (FA) with the definition based upon high speed dynamic indocyanine green angiography (HSDICGA). Methods: 300 consecutive patients with ARMD choroidal neovascular membranes (CNVMs), classified with FA, were reclassified based upon the morphology of the neovascular net in HSDICGA. All patients a general ophthalmologic examination, a dynamic FA and ICGA with the scanning laser ophthalmoscopes (Heidelberg HRA or Rodenstock SLO 101) at the baseline visit and at regular intervals during the follow up lasting 3 to 12 months. Three independent trained observers classified CNMVs on the bases of the two different angiographic techniques. Results: 73% of CNV classified as "classic" in FA showed an "occult" component in HSDICGA. 62% of CNV classified as "predominantly classic" with FA were classified as "minimally classic" in HSDICGA. Five different angiographic patterns of "occult" neovascularization were identified with HSDICGA: 1) retinal vascular anomalous complexes (RVAC); 2) subfoveal neovascular net associated with polypoidal choroidal vasculopathy (PVC); 3) well-defined net; 4) pseudo-microaneurismal net; 5) poorly defined net. Patterns 1,2 and 3 remained stable during follow up, whereas about half of CNVM with patterns 4 and 5 changed into a well-defined net (pattern 3). Conclusions: HSDICGA allowed a substantially better classification of subfoveal choroidal neovascularization due to its possibility to identify the "occult" component of CNV and to better evaluate its size, subtypes and evolution.
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