Indocyanine green angiography of exudative age-related macular degeneration

Adam Martidis, Ronald P. Danis, Thomas A. Ciulla, Alon Harris

Research output: Contribution to journalArticle

Abstract

Purpose: There are many conflicting reports on the utility of Indocyanine Green (ICG) Angiography in age-related macular degeneration (ARMD), with some authors reporting impressive rates of ICG delineation of choroidal neovascular membranes (CNVM) thought to be occult or poorly demarcated on fluorescein angiography. We sought to further assess the role of ICG angiography by determining the conditions under which ICG angiography was most revealing. Methods: We performed a retrospective review of al! patients with exudative ARMD who underwent fluorescein and ICG angiography at our medical center between the years 1993-1996. Fluorescein angiograms were categorized as follows: 1. pigment epithelial detachment with no CNVM detected, 2. classic plus occult CNVM, 3. occult CNVM in the form of a fibrovascular pigment epithelial detachment or late leakage of undetermined source based on Macular Photocoagulation Study (MPS) parameters, 4. poorly demarcated CNVM secondary to subretinal hemorrhage or hard exudate, or 5. a combination of subretinal hemorrhage plus features of categories 1, 2, or 3, above. ICG angiographie findings were classified as follows: 1. "hot spot," 2. placqoid region, 3. no evidence of CNVM. The ICG angiograms were then assigned a utility-based grading of nondelineating, delineating but not affecting treatment, or delineating and affecting management. Res B Its: Overall, ICG angiography was delineating and affecting management in 15/48 (31%) cases of exudative ARMD. In terms of the subcategories listed above, ICG angiography was delineating and affecting management in 1/4 (25%) cases of pigment epithelial detachment, 1/5 (20%) cases of classic plus occult CNVM, 4/15 (27%) cases of occult CNVM, 2/5 (40%) cases of poorly demarcated CNVM secondary to subretinal hemorrhage or hard exudate, and 7/19 (37%) cases of a combination of subretinal hemorrhage with features of categories 1, 2, or 3. Conclusions; ICG angiography is most helpful in cases of exudative ARMD in which subretinal hemorrhage obscures the boundaries of a CNVM. However, cases of other types of occuh CNVM in which ICG aids in precise delineation (such as determining eligibility for treatment by MPS criteria) are less common and highly dependent on subjective interpretation of the studies.

Original languageEnglish (US)
Pages (from-to)S239
JournalInvestigative Ophthalmology and Visual Science
Volume38
Issue number4
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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