[Indocyanine green angiography and subretinal neovascularization. Patterns in age related macular degeneration]

To determine the different angiographic patterns of neovascular membranes with indocyanine green in age-related macular degeneration (ARMD) and to establish the phase in which neovascularizations can be visualized most frequently.

We studied 56 eyes from 55 patients with a diagnosis of ARMD between April 98 and April 99. All patients underwent indocyanine green (ICG) and fluorescein digital videoangiography. We evaluated the pattern and the moment of identification of the neovascular membrane with both procedures.

We found that 13 out of 56 eyes (23.2%) presented well-defined subretinal neovascularization in fluorescein videoangiography while 43 (76.8%) showed an occult pattern. ICG videoangiography was able to identify choroidal neovascularization in 89.3% of cases. The following patterns were found: Type I: visible neovascularization (17.9%), Type II: well-defined membranes with hypofluorescent margin (33.9%), Type III: high fluorescent focal membranes (hot-spots) (8.9%), Type IV: hyperfluorescent plaques that appeared only in late phases (10.7%), Type V: mixed types (17.9%). A high percentage of choroidal neovascularization was observed in early or medium phases of the angiogram (85.4%).

Choroidal neovascularization in ARMD can appear with different patterns in the ICG videoangiographic study. The most frequently found pattern was that of well-defined membranes with a hypofluorescent margin. A high percentage of cases can be already visualized in the early phases of the angiogram.