ANALYSIS OF VASCULARIZED PIGMENT EPITHELIAL DETACHMENTS USING INDOCYANINE GREEN VIDEOANGIOGRAPHY

Background: Occult choroidal neovascularization (CNV) secondary to age -related macular degeneration (AMD) is known to occur with and without an associated serous pigment epithelial detachment (PED). Digital ind ocyanine green (ICG) videoangiography has been reported to provide enh anced definition of occult CNV. Methods: A total of 244 of 657 (37%) c onsecutive patients with AMD, with occult CNV and an associated serous PED evident on fluorescein angiographic examination, were further stu died with ICG videoangiography. Results: On ICG videoangiographic exam ination, 9 of the 244 (4%) eyes had no evidence of underlying CNV, or essentially a pure serous PED. Each of the remaining 235 eyes (96%) ha d evidence of neovascularization and were defined as having a vascular ized PED. These eyes were further divided into two groups, depending o n the size and delineation of the neovascularization seen. Of the 235 eyes with vascularized PEDs, 89 (38%) had a solitary area of neovascul arization that was well delineated, no more than one disc area in size , and defined as focal CNV. The other 146 (62%) eyes had a larger area of neovascularization, with variable delineation, defined as plaque C NV. Based on conventional guidelines, some patients were considered to be potentially eligible for laser photocoagulation treatment. Conclus ion: The results of this study suggest that ICG videoangiography may b e an important adjunct to the diagnosis, classification, and potential treatment of patients with AMD and occult CNV associated with a serou s PED (vascularized PED).