INDOCYANINE GREEN VIDEOANGIOGRAPHY AFTER ACUTE RETINAL-PIGMENT EPITHELIAL TEARS IN AGE-RELATED MACULAR DEGENERATION

PURPOSE: To determine the features of combined fluorescein and indocya nine green videoangiography after acute retinal pigment epithelial tea rs associated with age related macular degeneration. METHODS: We perfo rmed combined fluorescein and indocyanine green videoangiography in th ree eyes of three patients 2 days to 2 months after the development of tears of the retinal pigment epithelium. RESULTS: The area of exposed choroid in a retinal pigment epithelial tear shows intense hyperfluor escence in fluorescein videoangiography; in contrast, this area demons trates near-normal choroidal fluorescence on an indocyanine green vide oangiogram. The folded and retracted flap of retinal pigment epitheliu m in a retinal pigment epithelial tear discloses marked hypofluorescen ce on the fluorescein videoangiogram; in contrast, this flap of retina l pigment epithelium displays varying degrees of hyperfluorescence on the indocyanine green videoangiogram. CONCLUSIONS: The angiographic di fferences between fluorescein and indocyanine green result from the di stinct biophysical properties of these two dyes as well as from the di fferential penetra tion of their fluorescence through such pigmented s tructures as retinal pigment epithelium. Compared with fluorescein vid eoangiography, indocyanine green videoangiography allows better visual ization of choroidal neovascular membranes within the rolled-up and re tracted flap of the retinal pigment epithelial tear.