INDOCYANINE GREEN ANGIOGRAPHY AND AGE-RELATED SEROUS PIGMENT EPITHELIAL DETACHMENT

Background: Fundus fluorescein angiography has shown that pigment epit helial detachment in age-related macular degeneration is often associa ted with choroidal neovascularisation (CNV). Indocyanine green angiogr aphy (ICG-A) provides a better visualisation of choroidal circulation and of CNV than fluorescein angiography (FA). Methods: We studied the ICC angiograms of 58 eyes presenting age-related pigment epithelial de tachment, either with signs of occult CNV (48 eyes) or without signs o f CNV (10 eyes) on FA. In selected cases the neovascular complex defin ed on the ICG angiogram was photocoagulated. Results: ICG-A revealed h yperfluorescence interpreted as CNV in 46 of 48 eyes with fluorescein angiographic signs of occult choroidal neovascularisation. The neovasc ular complex seen on the ICG angiogram was well delineated in 29 eyes and ill defined in 17 eyes. ICG-A revealed CNV in 2 of 10 eyes without signs of CNV on FA. In these two cases the neovascular complex was il l defined. Photocoagulation in selected cases resulted in stabilisatio n or even improvement of visual acuity and flattening of the pigment e pithelial detachment in 9 of 18 cases. Conclusion: ICG-A may offer a b etter definition of the neovascular complex associated with pigment ep ithelial detachment in age-related macular disease and be helpful in g uiding laser treatment. In some cases FA still outlines more clearly t he lesions to be treated. FA and ICG-A should thus be used concurrentl y to determine treatment strategy.