Indocyanine green angiographic findings in idiopathic choroidal neovascularisation

Purpose The authors report the cases of two patients affected with idiopath ic choroidal neovascularisation studied with combined fluorescein angiograp hy and indocyanine green (ICG) angiography. In particular the presence of c horoidal abnormalities at ICG angiography which could not be detected by fl uorescein angiography was studied. Methods Both patients underwent a complete systemic and ocular assessment. Fluorescein angiography and ICG angiography were performed in a routine fas hion at the time of presentation in both cases and after 14 months in the s econd patient. Results Results of the systemic investigations were unremarkable. A distinc t dark rim surrounding the choroidal neovascular net was evident until the late phases of ICG angiography despite the presence of subretinal blood. Di lated choroidal vessels were observed beneath the neovascular membrane in b oth cases. In the first patient a hyperfluorescent area beyond the primary lesion was detected in the affected eye and a distinct leaking subfoveal ch oroidal venous vessel was found in the fellow eye. The second patient never showed other angiographic alterations either in the affected or in the fel low eye. Conclusions ICG angiography has proved to be useful, both to better define and follow up the true extent of the pigment halo (healing response) around the neovascular membrane when subretinal blood and dye leakage at fluoresc ein angiography prevent its full appreciation, and to rule out other causes of choroidal neovascularisation in young healthy adults associated with ei ther choroidal inflammatory focal lesions or choroidal vascular dynamic or inflammatory alterations.