ANGIOGRAPHIC FEATURES AND OUTCOME OF QUESTIONABLE RECURRENT CHOROIDALNEOVASCULARIZATION

PURPOSE: We sought to identify specific fluorescein angiographic patte rns that may have led to the diagnosis of questionable recurrent choro idal neovascularization. We evaluated follow-up information to determi ne whether any specific angiographic patterns could be used to identif y patients at high risk for definite recurrence. METHODS: We identifie d fluorescein angiograms graded as questionable for recurrent choroida l neovascularization that were taken from a previous prospective study involving 401 consecutive follow-up visits of patients treated with p hotocoagulation for choroidal neovascularization. We reviewed these an giograms to identify specific angiographic patterns that might have le d to the classification of questionable recurrent choroidal neovascula rization. Angiograms from visits subsequent to a questionable recurren ce were reviewed to determine which patterns, if any, were associated with an increased risk for a definite recurrence to develop later. RES ULTS: Forty four eyes (44 patients) with questionable recurrences (of which 40 had at least four months of follow-up) were categorized into six angiographic patterns. The three most common patterns included the following: (1) focal staining along the edge of the laser lesion (20 cases, 15 subsequently recurred); (2) blocked fluorescence from subret inal hemorrhage not documented at the previous visit (eight cases, fiv e subsequently recurred); (3) speckled hyperfluorescence noted beyond the edge of the laser lesion (eight cases, six subsequently recurred). CONCLUSIONS: Questionable recurrent choroidal neovascularization may be identified by specific angiographic patterns. Focal staining along the edge of the laser lesion and speckled hyperfluorescence were the p atterns that were most likely to progress to definite recurrence.