Discrepancy between indocyanine green and fluorescein angiography in occult choroidal neovascularization

Six eyes without or with minimal evidence of choroidal neovascularization on fluorescein angiography are presented. All six eyes have marked retinal pigment epithelial alterations. Indocyanine green angiography reveals extensive hyperfluorescence, indicative of choroidal neovascularization undermining the macula in these six eyes. It is surprising that three eyes are asymptomatic and two others have a relative good visual acuity. It is suggested that hyperfluorescence observed by indocyanine green angiography without or with minimal late dye diffusion on fluorescein angiography could indicate a slow progression and thus a better prognosis of the maculopathy.