Simultaneous indocyanine green and fluorescein angiography in retinal pigment epithelium tear using the confocal scanning laser ophthalmoscope

PURPOSE: To describe the indocyanine green angiographic pattern of retinal pigment epithelium tears in the setting of age-related macular degeneration compared with the fluorescein angiographic features. METHODS: Twelve consecutive patients (12 eyes) with a retinal pigment epith elium tear underwent simultaneous indocyanine green angiography and fluores cein angiography with the confocal scanning laser ophthalmoscope. The findi ngs for the two modes were compared, RESULTS: Choroidal neovascular membrane was evident beneath the rolled reti nal pigment epithelium on indocyanine green angiograms in 11 (92%) of 12 ey es: a focal neovascular membrane was apparent in five (42%) of 12 eyes, whe reas a plaque neovascular membrane was seen in six (50%) of 12 eyes. In com parison, fluorescein angiography demonstrated late leakage as a result of o ccult choroidal neovascular membrane in nine (82%) of 11 eyes but no well-d efined choroidal neovascular membrane. CONCLUSIONS: Indocyanine green angiography is superior to fluorescein angio graphy for imaging choroidal neovascularization in cases of retinal pigment epithelium tear and may serve as an important adjunct to indocyanine green -guided laser treatment in selected cases. (Am J Ophthalmol 1999;128:331-33 9. (C) 1999 by Elsevier Science Inc. All rights reserved.)