Abstract
Purpose The authors report the cases of two patients affected with idiopathic choroidal neovascularisation studied with combined fluorescein angiography and indocyanine green (ICG) angiography. In particular the presence of choroidal abnormalities at ICG angiography which could not be detected by fluorescein angiography was studied.
Methods Both patients underwent a complete systemic and ocular assessment. Fluorescein angiography and ICG angiography were performed in a routine fashion at the time of presentation in both cases and after 14 months in the second patient.
Results Results of the systemic investigations were unremarkable. A distinct dark rim surrounding the choroidal neovascular net was evident until the late phases of ICG angiography despite the presence of subretinal blood. Dilated choroidal vessels were observed beneath the neovascular membrane in both cases. In the first patient a hyperfluorescent area beyond the primary lesion was detected in the affected eye and a distinct leaking subfoveal choroidal venous vessel was found in the fellow eye. The second patient never showed other angiographic alterations either in the affected or in the fellow eye.
Conclusions ICG angiography has proved to be useful, both to better define and follow up the true extent of the pigment halo (healing response) around the neovascular membrane when subretinal blood and dye leakage at fluorescein angiography prevent its full appreciation, and to rule out other causes of choroidal neovascularisation in young healthy adults associated with either choroidal inflammatory focal lesions or choroidal vascular dynamic or inflammatory alterations.
Similar content being viewed by others
Article PDF
References
Gass JDM . Pathogenesis of disciform detachment of the neuroepithelium. Am J Ophthalmol 1997;63:661–87.
Green WR, Wilson DJ . Choroidal neovacularisation. Ophthalmology 1986;93:1169–76.
Inagaki M, Harada T, Kiribuchi T, Ohashi T, Majima J . Subfoveal choroidal neovascularization in uveitis. Ophthalmologica 1996;210:229–33.
Gass JMD . Stereoscopic atlas of macular disease, diagnosis and treatment, 3rd ed. St Louis: Mosby, 1987:198–200.
Macular Photocoagulation Study Group. Argon laser photocoagulation for idiopathic neovascularization: results of a randomized clinical trial. Arch Ophthalmol 1983;101:1347–61.
Macular Photocoagulation Study Group. Krypton laser photocoagulation for idiopathic neovascularization: results of a randomized clinical trial. Arch Ophthalmol 1990;108:832–7.
Davis WT, Sheppard E . Juvenile macular exudative retinitis (Junius). Arch Ophthalmol 1935;13:960.
Cleasby GW . Idiopathic foveal subretinal neovascularization. Am J Ophthalmol 1976;81:590–6.
Soubrane G, Koenig F, Coscas G . Choroidopathie maculaire hemorragique du sujet jeune. J Fr Ophtalmol 1983;6:25–34.
Bottom FG, Deutman AF . Idiopathic subretinal neovascular membranes in the macula (hemorrhagic macular choroidopathy of the young adults). Clinical report and effectiveness of laser treatment. Doc Ophthalmol 1987;64:311–43.
Ho AC, Yannuzzi LA, Pisicano K, De Rosa J . The natural history of idiopathic choroidal neovascularization. Ophthalmology 1995;102:782–9.
Cohen SY, Laroche A, Leguen Y, Soubrane G, Coscas G . Etiology of choroidal neovascularization in young patients. Ophthalmology 1996;103:1241–4.
Giovannini A, Scassellati-Sforzolini B, et al. Indocyanine green angiographic findings in idiopathic choroidal neovascularization. Int Ophthalmol 1996;20:171–9.
Iida T, Hagimura N, Kishi S, Shimizu K . Indocyanine green angiographic features of idiopathic submacular neovascularization. Am J Ophthalmol 1998;126:70–6.
Grossniklaus HE, Gass JDM . Clinicopathologic correlations of surgically excised type 1 and type 2 submacular choroidal neovascular membranes. Am J Ophthalmol 1998;126:59–69.
Lopez PF, Lambert HM, Grossniklaus HE, Sternberg P . Well-defined subfoveal choroidal neovascular membranes in age-related macular degeneration. Ophthalmology 1993;100:415–22.
Grossniklaus HE, Hutchinson AK, Capone A, Woolfson J, Lambert HM . Clinicopathologic features of surgically excised choroidal neovascular membranes. Ophthalmology 1994;101:1099–111.
Gass JDM . Biomicroscopic and histopathologic considerations regarding the feasibility of surgical excision of subfoveal neovascular membranes. Am J Ophthalmol 1994;118:285–98.
Campochiaro PA, Morgan KM, Conway BP, Stathos J . Spontaneous involution of subfoveal neovascularization. Am J Ophthalmol 1990;109:668–75.
Glaser BM, Campochiaro PA, Davis JL Jr, Jerdan JA . Retinal pigment epithelial cells release inhibitors of neovascularization. Ophthalmology 1987;94:780–4.
Miller H, Miller B, Ryan SJ . The role of the retinal pigment epithelium in the involution of subretinal neovascularization. Invest Ophthalmol Vis Sci 1986;27:1644–52.
Slakter JS, Giovannini A . Multifocal choroiditis and the presumed ocular histoplasmosis syndrome. In: Yannuzzi LA, Flower RW, Slakter JS, editors. Indocyanine green angiography. St Louis: CV Mosby, 1997:271–8.
Slakter JS, Giovannini A, Yannuzzi LA, et al. Indocyanine green angiography of multifocal choroiditis. Ophthalmology 1997;104:1813–9.
Akman A, Kadayficilar S, Aydin P . Indocyanine green angiography findings in a case of punctate inner choroidopathy. Eur J Ophthalmol 1998;8:190–4.
Tiffin PA, Maini R, Roxburgh ST, Ellingford A . Indocyanine green angiography in a case of punctate inner choroidopathy. Br J Ophthalmol 1996;80:90–1.
Brown J Jr, Folk JC . Current controversies in the white dot syndromes: multifocal choroiditis, punctate inner choroidopathy, and the diffuse subretinal fibrosis syndrome. Ocul Immunol Inflamm 1998;6:125–7.
Wyhinny GJ, Jackson JL, Jampol LM, Caro NC . Subretinal neovascularization following multiple evanescent white dot syndrome. Arch Ophthalmol 1990;108:1384–5.
Jampol LM, Wiredu A . MEWDS, MFC, PIC, AMN, AIBSE and AZOOR: one disease or many? [editorial] Retina 1995;15:373–8.
Obana A, Kusumi M, Miki T . Indocyanine green angiographic aspects of multiple evanescent white dot syndrome. Retina 1996;16:97–104.
Guyer DR, Yannuzzi LA, Slakter JS, Sorenson JA, et al. Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol 1994;112:1057–62.
Cardillo Piccolino F, Borgia L, et al. Indocyanine green angiographic findings in central serous chorioretinopathy. Eye 1995;9:324–32.
Thomas JW, Grossniklaus HE, Lambert HM, et al. Ultrastructural features of surgically excised idiopathic subfoveal neovascular membranes. Retina 1993;13:93–8.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gharbiya, M., Pantaleoni, F., Grandinetti, F. et al. Indocyanine green angiographic findings in idiopathic choroidal neovascularisation. Eye 13, 621–628 (1999). https://doi.org/10.1038/eye.1999.170
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/eye.1999.170
Keywords
This article is cited by
-
Dark halo, a new biomarker in macular neovascularization: comparison between OCT angiography and ICGA—a pilot prospective study
Graefe's Archive for Clinical and Experimental Ophthalmology (2022)