Angiographic pattern of recurrent choroidal neovascularization in age-related macular degeneration

• Published in: Eye (London) Vol. 18; no. 7; pp. 685 - 690
• Main Authors: BATTAGLIA PARODI, M, DA POZZO, S, RAVALICO, G
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.07.2004
• Subjects: Aged; Biological and medical sciences; Choroidal Neovascularization - etiology; Choroidal Neovascularization - pathology; Choroidal Neovascularization - surgery; Coloring Agents; Female; Fluorescein Angiography; Follow-Up Studies; Humans; Indocyanine Green; Laser Coagulation; Macular Degeneration - complications; Male; Medical sciences; Middle Aged; Ophthalmology; Prospective Studies; Recurrence; Retinopathies; Relapse; Retinopathy; Radiodiagnosis; Angiography; Choroidal neovascularization; fluorescein angiography; Macula disciform degeneration; Maculopathy; Recurrent; recurrent choroidal neovascularization; Macular degeneration; Eye disease; indocyanine green angiography; Ophthalmology; age-related macular degeneration; Age
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/sj.eye.6701316

To evaluate the angiographic characteristics of recurrent choroidal neovascularization (R-CNV) in age-related macular degeneration (AMD). A prospective investigation on 107 consecutive patients with exudative AMD and CNV not involving the fovea was conducted. Fluorescein angiography (FA) and indocyanine green angiography (ICGA) were planned before krypton laser treatment, and after 3 weeks, 2, 3, 4, 6, 9, 12, 18, and 24 months from photocoagulation. Laser treatment was FA-guided in eyes with classic CNV, and ICGA-guided in eyes with occult CNV on FA. At baseline on FA, 23.3% had classic CNV, whereas, 76.6% showed occult CNV. On ICGA, CNV assumed a focal and a plaque pattern in 81.3 and 18.6% of cases, respectively. Overall, post-laser CNVs occurred in 56 eyes. FA identified well-defined and ill-defined R-CNV in 25 and 75% of cases, respectively. ICGA identified three different R-CNV patterns: focal, annular, and plaque. Focal R-CNV was defined as a single dot-like hyperfluorescence, which was detected in 69.6% of cases, with subfoveal location in half of them. Annular R-CNV was identified by a hyperfluorescent lesion, partially or completely encircling treated area, which was visible in 19.6% of cases, all with subfoveal involvement. Plaque R-CNV was defined as a hyperfluorescent lesion larger than 1 disc diameter in size, and was seen in 10.7% of cases, all with subfoveal location. ICGA is able to improve R-CNV visualization identifying three different R-CNV patterns. Focal R-CNV is the most frequent pattern and can be re-treated in half of the cases.