Indocyanine green angiographic features prognostic of visual outcome in the natural course of patients with age related macular degeneration

Aims-To determine indocyanine green (ICG) angiographic features prognostic of visual acuity loss in eyes following a natural course of exudative age r elated macular degeneration (AMD). Methods-89 eyes of 72 patients (48 men, 24 women) aged between 50 and 87 ye ars old (mean 69.5 (SD 8.8) years) with classic and/or occult choroidal neo vascularisation (CNV) were reviewed. ICG angiographic features were classif ied as follows: type 1, well demarcated hyperfluorescence with late ICG lea kage; type 2, well demarcated hyperfluorescence with no late dye leakage; t ype 3, poorly demarcated hyperfluorescence; type 4, no hyperfluorescence. F ollow up ranged from 6 to 67 months (mean 19.2 (11.5) months). Logistic reg ression analyses were performed using change of visual acuity (worse or not ) as the dependent variable, and patient age, sex, characteristics of fluor escein angiography (classic or occult CNV), location of CNV, and each ICG t ype as the independent variables. Odds ratios (ORs) and 95% confidence inte rvals (CIs) were calculated. Results-Type 1 CNV was associated with the highest risk for visual acuity l oss (OR: 7.50, CI: 1.42-39.55, p = 0.018) among the present variables. In c ontrast, CNV having no ICG leakage (type 2, 3, and 4), represented no signi ficantly increased risk. Conclusion-Well demarcated hyperfluorescence with late ICG leakage appears to be predictive of visual acuity loss in eyes with CNV. Thus, ICG angiogra phy may offer a useful means of predicting visual outcomes in AMD.