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L Migliavacca, N Orzalesi, M Di Napoli, L Vitale; Characteristics of "Plaques" in Occult and Classic CNV of AMD . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2504.
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Purpose: To determine the prevalence and the evolution of the so-called "plaques" in age-related choroidal neovascular membranes (CNVMs) using high speed dynamic angiography (HSDA) and to correlate visual acuity with the presence or absence of the "plaques". Methods: 100 consecutive patients (136 eyes) with "occult" or "occult" and "classic" CNVMs with visual acuity better than 20/200 underwent a general ophthalmologic examination including visual acuity testing with ETDRS charts. HSD fluorescein angiography (FA) and HSD indocyanine green angiography (ICGA) by means of a scanning laser ophthalmoscope (SLO, Heidelberg HRA, Ottobrun, Germany) were performed at baseline visit and at regular intervals during follow up. Control visits were performed every one-four months depending on the characteristics of the CNVM. Follow-up ranged from 12 to 23 months. The dimension of the entire neovascular net and the dimension of the "plaque", when it was present, were measured with the software of the HRA. Results: HSDICGA performed with SLO allowed a precise visualization of the boundaries of the "occult" neovascular net during the early phases of the angiography, whereas late phases, recorded 50 minutes after injection, allowed the recognition of the "plaques". Neovascular profiles were shown by HSDICGA in all of 136 eyes of the study whereas only 38.5 % showed "plaques" in late phases. CNVMs "occult" on FA showed a greater prevalencee of "plaques" (59 %) whereas "minimally classic" and "predominantly classic" CNVM on FA showed a plaque prevalence of 21%. 95% of the "plaques" increased in size during follow-up and lesions with a "plaque" showed a mean visual acuity decrease of 2.5 lines during the follow-up, whereas lesions without "plaques" showed a mean visual acuity decrease of 3.9 lines. Conclusion: This study confirms that "plaques" seen in the late phases of HSDICGA may be absent in many cases of "occult" CNVMs. The size of the "occult" component shown by HSDA largely exceeds the size of the "plaque". HSDICGA appears superior to conventional FA in detecting the occult component of CNVMs.
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