Indocyanine green angiography in age-related macular degeneration with occult neovascularization

This study has been conducted to assess the sensitivity of indocyanine green angiography (ICGA) in detecting choroidal neovascularization (CNV) in patients with age-related macular degeneration (ARMD) with occult CNV at fluorescein angiography (FA) and to establish their eligibility for laser photocoagulation. Three hundred eighty-three eyes of 355 consecutive patients with occult CNV at FA were studied by ICGA; occult CNV with or without pigment epithelial detachment (PED) were detected as well. Eligibility for laser treatment was established on the basis of the ICGA-guided CNV extension and localization. Out of 157 eyes (41%) with occult CNV and FED, 74 (47.1%) showed focal ICGA CNV 35 eyes (22.3%) had plaque CNV. Thirty-five eyes with FED (22.3%) appeared serous without CNV, and in 13 eyes (8.3%) no CNV was detectable because of large hemorrhages. Out of the 226 eyes (59%) presenting occult CNV without FED, 94 eyes (41.6%) had plaque CNV, and 58 (25.7%) had focal CNV. In 74 eyes (32.7%), there was no detectable CNV or only an ill-defined ICGA appearance. ARMD with FED is closely associated with focal CNV, while plaque CNV is largely found in exudative ARMD without FED (p < 0.001), Considering all the cases examined by ICGA, CNV was evident in 261 eyes (68%) occult at FA, Extrafoveal CNV laser treatment was recommended for 103 eyes (27%), Our results suggest that ICGA may be useful in the diagnosis and management of ARMD with occult CNV at FA increasing the number of patients eligible for laser treatment.