ICGA Findings and Clinical Features of Idiopathic Choroidal Neovascularization

PURPOSE: The purspose of this study was to investigate the ICGA findings and clinical features of idiopathic choroidal neovascularization (CNV) which is one of the important causes of CNV developed under 50 years of age. METHOD: We performed FAG and ICG angiography in 26 eyes (25 patients) which were diagnosed as idiopathic CNV and investigated the visual acuity, associated retinal findings, and treatment modality. RESULTS: The locations of CNV were subfoveal in 11 eyes, juxtafoveal in 11 eyes, extrafoveal in 4 eyes. All CNV were less than 1 disc diameter in size. On ICG angiography, hyperfluorescent neovascular network CNV was visible in early phase in 22 out of 26 eyes. Twelve eyes had dark rim surrouding the CNV, and 10 eyes had focal choroidal vascular dilation near the CNV. Twelve eyes showed obvious choroidal hyperpermeability in late phase, and 3 eyes showed the hypofluorescent dark spot near the CNV. Final visual acuity was improved in 9 eyes, decreased in 4 eyes, and unchanged in 13 eyes. CONCLUSION: Idiopathic CNV was small in size and located mostly in foveal area. ICG angiography showed CNV with various angiographic patterns, and the visual prognosis was relatively good.

Clinical features of Choroidal Neovascularization in Patient with High Myopia

PURPOSE: To investigate the clinical features and ICGA findings of choroidal neovascularization(CNV) in patients with high myopia which could be one of the important causes of CNV. METHODS: We performed FAG and ICG angiography in 21 high myopic patients(23 eyes) with CNV and investigated the visual acuity, associated retinal findings, and treatment modality. RESULTS: The locations of CNV were extrafoveal in 6 eyes(26.1%), juxtafoveal in 13 eyes(56.5%), and subfoveal in 4 eyes(17.4%). All cases of CNV were less than 1 disc diameter in size. On ICG angiography, CNV was better visible in late phase in 8 out of 23 eyes(34.8%) and 5 eyes(21.7%) had better fluorescence in early phase. In 7 eyes(30.4%), CNV was evident only in late phase. In 3 eyes(13.1%), CNV was very poorly visible with ICG angiography in both phases. Final visual acuity was improved in 4 eyes(17.4%), decreased in 6 eyes(26.1%), and unchanged in 13 eyes(56.5%). CONCLUSION: CNV in high myopia was small in size and located mostly in foveal area. ICG angiography showed CNV with different angiographic patterns, but most cases of CNV had better fluorescence in late phase. The visual prognosis was relatively good.

Choroidal Ne ovascularization in Patients with Chronic Central Serous Chorioretinopathy

Chronic central serous chorioretinopathy[CSC], which also has been termed diffuse retinal pigment epitheliopathy, is defined as a sensory retinal detachment associated with areas of RPE atrophy and pigment mottling. Fluorescein angiographic finding includes areas of granular hyperfluo-rescence and one or many subtle leaks. In older age group, choroidal neo-vascularization[CNV]may develop as a complication. We investigated the clinical features and performed fluorescein angiography[FAG], indocyanine green[ICG]angiography in 10 patients with CNV among 32 patients with chronic CSC. The location of CNV was extrafoveal[3 eyes]and juxtafoveal[7 eyes]. Associated fundus findings were RPE atrophy[8 eyes], PED[5 eyes], serous RD[4 eyes], subretinal hemorrhage[4eyes]. ICG findings were hypo-fluorescence[8 eyes], choroidal hyperpermeability[7 eyes], choroidal delayed filling[5 eyes]. Choroidal neovascularization was identified only with ICG angiography in 6 out of 10 cases. Laser photocoagulation was performed using ICG angiography in 6 cases. Visual acuity was improved in 4 out of 10 cases, and unchanged in 3 out of 10 cases. Therefore, we suggest that ICG angiography may be used as an important device for the diagnosis and management of CNV in patients with chronic CSC. Visual prognosis of CNV in chronic CSC seems to be relatively good.

Atrophic Tracts of Retinal Pigment Epithelium in Central serous Chorioretinopathy and Its Angiographic Findings

Atrophic tracts of the retinal pigment epithelium are angiographic images of the posteior pole, esp, inferior hemispheric retina. It is likely that serous detachment of the neuroepithelium constituting the central serous chorioretinopathy (CSC) of the posterior pole prolongs itself downwards, leaving a localized atrophy as a mark on the pigmented epithelium. In this study, they are presented in 8 cases (10 eyes) afected jointly by the CSC. All of the patients were male. The average age at the time of follow-up examination was 44.5 years. One of 10 eyes was noted to have clinically discernible, dependent peripheral retinal detachment. Retinal pigment epithelial atrophic tracts in this study were classified by 3 patterns in the FAG. One pattern presents as an irregular atrophic tract, which almost is located at the watershed zone near the temporal margin of the optic disc. Another pattern presents as the atrophic tract with a vertical line, which coursed vertically from the posterior pole into the inferior fundus. The other pattern composes of the two previous patterns. The atrophic tract of the RPE in the FAG showed hyperfluorescence. The lesions within the atrophic tracts of the RPE showed several depigmented spots and a pronounced window defect in the FAG. In the ICG angiography, the atrophic tracts of the tetinal pigment epithelium showed hypofluorescence distinctly during late phase of the ICG angiography.

The Variants of Macular Choroidal Veins in ICG Angiography

The choroidal vascular structure in macula is anatomically different from that in other region. And choroidal venous drainage in macula represents various types. This study attempted to classify the choroidal venous drainage in macula and focused on the relationship between the choroidal venous drainage type and a disease involving macula, esp. age-related macular degeneration(ARMD). The authors performed indocyanine green(ICG) angiography in 115 eyes (93 patients) without macular disease and in 31 eyes (24 patients) with ARMD, which were presented with choroidal new vessels. The choroidal venous drainage in macula was classified as 4 types. They were superotemporal drainage, inferotemporal drainage, horizontal watershed, and irregular type. The most common type of choroidal venous drainage was horizontal watershed type which was showed in 55 eyes (48%) without macular diease and 15 eyes (48%) with ARMD. Any relationship between a type of choroidal venous, drainage and ARMD was not found.