Indocyanine-green angiography in patients with occult choroidal neovascularization

Several studies have stressed the role of indocyanine-green (ICG) angiography in patients with occult choroidal neovascularization (O-CNV) secondary to age-related maculopathy (ARM). The present study was undertaken to evaluate the percentage of eyes that could be converted from O-CNV without suffering pigment epithelial detachment (PED) in well-defined CNV using ICG angiography with a scanning laser system. A total of 112 patients with ARM and O-CNV without PED were included in this prospective study. All patients underwent ICG angiography with a scanning laser system. The early phase (first 3 min) of the ICG angiogram was analyzed for the presence of a neovascular network, whereas focal or irregular hyperfluorescence was noted in the late phase. The early phase of the ICG angiograms revealed in 62 (55%) eyes a well-defined CNV. In 55 of these eyes, late irregular hyperfluorescent and hypofluorescent zones were observed. Another 27 eyes presented with focal hyperfluorescent areas in the latephase studies without having shown a well-demarcated area of neovascularization in the early phase of the ICG angiogram. This study confirms that ICG angiography is an important adjunctive method to fluorescein angiography. In more than 50% of eyes with O-CNV the ICG angiograms obtained with a scanning laser ophthalmoscope enable the visualization of a neovascular network in the early phase.