INDOCYANINE GREEN HYPERFLUORESCENCE ASSOCIATED WITH SEROUS RETINAL-PIGMENT EPITHELIAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION

Purpose: Indocyanine green (ICG) angiography may improve visualization of choroidal neovascularization (CNV) associated with serous retinal pigment epithelial detachment (RPED) in age-related macular degenerati on (AMD). The features of ICG hyperfluorescence associated with serous RPED and therapeutic effect of ICG-directed laser photocoagulation in eyes with serous RPED is evaluated. Design: Retrospective review of a ll simultaneous fluorescein/ICG angiograms (n = 918) performed over an 18-month period to identify 44 eyes in 39 patients with serous RPED s econdary to AMD on fluorescein angiography. Participants: Thirty-nine patients with AMD, aged 53 to 89 years, participated. Intervention: Ey es were nonrandomly treated with ICG-directed laser photocoagulation o r observation. Main Outcome Measures: Characteristics of ICG hyperfluo rescence associated with a serous RPED are reviewed. Final visual acui ty and anatomic appearance of the serous RPED are given. Results: Twen ty-three (52%) of the 44 eyes had an isolated serous RPED without obvi ous CNV, and 21 (48%) of the 44 eyes had a serous RPED associated with occult CNV on fluorescein angiography. Indocyanine green angiography demonstrated underlying CNV in 19 eyes (83%) with an isolated serous R PED and in all 21 eyes (100%) with serous RPED and occult CNV. The pat tern of ICG hyperfluorescence revealed focal CNV in 15 eyes and plaque CNV in 4 eyes with an isolated serous RPED. In eyes with serous RPED and occult CNV, focal CNV and plaque CNV were noted with ICG in 8 and 13 eyes, respectively. No follow-up was available for two eyes. Twenty eyes were treated with ICG-directed laser photocoagulation. In these eyes, the visual acuity remained stable in 6 eyes (30%) and decreased in 14 eyes (70%). Twenty-two eyes were observed, and the visual acuity remained stable in 8 (36%), improved in 2 (9%), and decreased in 12 e yes (55%). Conclusions: Although ICG angiography may enhance visualiza tion of CNV associated with serous RPED in AMD, ICG-directed laser tre atment did not appear to improve visual acuity when compared with obse rved eyes in this series.