Hyperfluorescence associated with serous retinal pigment epithelial detachment on indocyanine green angiography

Purpose: Indocyanine green angiography has been reported to improve detecti on and delineation of occult choroidal neovascularisation in serous pigment epithelium detachment in age-related macular degeneration. The study aims to evaluate the visual acuity results of eyes affected by serous pigment ep ithelium detachment in age-related macular degeneration, having had indocya nine green-directed laser photocoagulation, and to correlate them to the pa ttern of serous pigment epithelium detachment on indocyanine green angiogra phy, Methods: Thirty-four eyes of 31 patients affected by serous pigment epithel ium detachment in age-related macular degeneration were prospectively consi dered. Each patient underwent an ophthalmological examination including flu orescein and indocyanine green angiography one day before, and 6 weeks, 3 m onths, 6 months, 9 months, 12 months and 24 months after krypton-laser trea tment, The serous pigment epithelium detachment was classified in the late- phases angiograms as either hypofluorescent, isofluorescent or hyperfluores cent comparing the fluorescence of the serous pigment epithelium detachment with the choroidal background fluorescence. Results: The indocyanine green-guided laser treatment was associated with a temporary stabilization and a long-term progressive reduction of visual ac uity: after 24 months visual acuity improved in 2.9%, stabilized in 26.5% a nd worsened in 70.5% of cases, Serous pigment epithelium detachment present ing a pretreatment hyperfluorescence had a final visual acuity of 0.06, wit h subfoveal choroidal neovascularisation development in 100% of cases, wher eas serous pigment epithelium detachment presenting a pretreatment hypofluo rescence and isofluorescence showed a final visual acuity of 0.12, with sub foveal choroidal neovascularisation development in 43.5% of eyes, with stat istically significant difference. Conclusion: Overall visual acuity decreases with time after indocyanine gre en-guided laser treatment of choroidal neovascularisation in serous pigment epithelium detachment, and serous pigment epithelium detachment becoming h yperfluorescent in the late-phases of indocyanine green angiography has the worst functional outcome.