INDOCYANINE GREEN ANGIOGRAPHIC FEATURES OF PATHOLOGICAL MYOPIA

PURPOSE: To analyze indocyanine green angiographic findings of patholo gic myopia and compare them with those of fluorescein angiography, wit h particular reference to the usefulness of indocyanine green angiogra phy in the management of neovascular complications. METHODS: Thirty-tw o consecutive patients (52 eyes) with pathologic myopia underwent a co mplete ophthalmologic examination including fluorescein and indocyanin e green angiography. RESULTS: Retrobulbar arteries and veins were visu alized solely on indocyanine green angiography in 33 (63%) of 52 eyes, Choroidal arteries appeared attenuated and reduced in number. In the area of staphyloma, choroidal veins were less numerous, and in all eye s an absence of the normal choroidal flush caused by the choriocapilla ris filling was observed. Subretinal and retinal hemorrhages were pres ent in 28 (54%) of 52 eyes. Choroidal neovascularization was diagnosed in 16 eyes on fluorescein angiography and in 18 eyes on indocyanine g reen angiography. In seven eyes, indocyanine green angiography disclos ed lacquer cracks (without choroidal neovascularization), appearing in the late phases as hypofluorescent lines, as the probable cause of th e subretinal and retinal hemorrhages, In only one eye did indocyanine green angiography fail to disclose choroidal neovascularization detect able on fluorescein angiography. In two eyes, neither dye could clarif y the origin of the hemorrhages. CONCLUSIONS: Indocyanine green angiog raphy allows identification of retrobulbar arteries and veins, and ana lysis of the altered choroidal vasculature, Moreover, indocyanine gree n angiography is a useful diagnostic tool to differentiate lacquer cra cks from choroidal neovascularization in retinal and subretinal hemorr hages.