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Indocyanine green angiographic features of myopic subfoveal choroidal neovascularization as a prognostic factor after photodynamic therapy.

Byeon SH, Kwon OW, Lee SC, Kim SS, Koh HJ - Korean J Ophthalmol (2006)

Bottom Line: At one-year follow-up after PDT, a younger age (p = 0.002) and the presence of a dark rim (p = 0.002) were significantly correlated with an improvement of visual acuity (decrement in logMAR) after PDT.Other factors had no significant influence on changes in visual acuity.Younger patients and patients with a dark rim on ICG angiography had a higher chance of visual improvement after PDT in myopic CNV.

View Article: PubMed Central - PubMed

Affiliation: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To determine the influence of clinical features and Indocyanine green (ICG) angiographic features on the visual outcome of patients with myopic sub-foveal choroidal neovascularization (CNV) who received photodynamic therapy (PDT).

Methods: Thirty-six consecutive patients (39 eyes) with myopic CNV who were followed up for more than one year after PDT were enrolled in this study. Clinical features included age, gender, refractive error, great linear dimension, and subretinal hemorrhage. ICG features included the lesion size, lacquer cracks, hypofluorescence surrounding the CNV (dark rim), peripapillary atrophy size, and visible prominent choroidal veins under the macula. Linear regression analysis was performed using the change in visual acuity (delta logMAR) as the dependent variable and the above factors as independent variables.

Results: At one-year follow-up after PDT, a younger age (p = 0.002) and the presence of a dark rim (p = 0.002) were significantly correlated with an improvement of visual acuity (decrement in logMAR) after PDT. Other factors had no significant influence on changes in visual acuity.

Conclusions: Younger patients and patients with a dark rim on ICG angiography had a higher chance of visual improvement after PDT in myopic CNV.

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Related in: MedlinePlus

ICG angiography of the right eye of a 58-year-old woman. At initial examination, the patient's best-corrected visual acuity was 20/63. The refractive error was -11.0 diopters. (3A) The mid-phase ICG angiography showed the lesion to be slightly more hyperfluorescent than the background. (3B) The late phase revealed dye leakage beyond the previous lesion with multiple lacquer cracks. (3C, 3D) At a 12-month follow-up, the patient's visual acuity had decreased to 20/200. The ICG angiography showed a similar appearance of the baseline ICG angiography despite four treatments of PDT during the previous 12 months. (3E, 3F) At the 24-month follow-up, the patient's visual acuity had returned to 20/125. During the 24-month follow-up, she had undergone PDT five times.
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Figure 3: ICG angiography of the right eye of a 58-year-old woman. At initial examination, the patient's best-corrected visual acuity was 20/63. The refractive error was -11.0 diopters. (3A) The mid-phase ICG angiography showed the lesion to be slightly more hyperfluorescent than the background. (3B) The late phase revealed dye leakage beyond the previous lesion with multiple lacquer cracks. (3C, 3D) At a 12-month follow-up, the patient's visual acuity had decreased to 20/200. The ICG angiography showed a similar appearance of the baseline ICG angiography despite four treatments of PDT during the previous 12 months. (3E, 3F) At the 24-month follow-up, the patient's visual acuity had returned to 20/125. During the 24-month follow-up, she had undergone PDT five times.

Mentions: Indocyanine green (ICG) angiography was performed with a scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Dossenheim, Germany). The ICG angiograms were reviewed by two examiners (SH Byeon and HJ Koh) to determine the lesion size on ICG angiography 「ratio of the total area of the lesion divided by the area of the optic disc (DA=Disc Area)」 and any associated findings, including hypofluorescence surrounding the CNV (dark rim), lacquer cracks, prominent large choroidal veins in the macula, and peripapillary choroidal atrophy size.21-24 The presence of an ICG angiographic dark rim (hypofluorescence around the CNV) was defined as a round-shaped background hypofluorescence within which a hyperfluorescent island appeared during the early phase (Fig. 1, 2).15-18 Lacquer cracks were identified using late-phase ICG angiography (Figures 1 and 3).16,22 Regarding the presence of visible large choroidal veins under the macula, the focal dilation of the choroidal veins in the posterior fundus during the early phase of ICG angiography was defined; some showed hyperfluorescence until the late-phase of the angiogram (Fig. 2).16,23 The area of peripapillary atrophy (islands of non-perfusion or reduced perfusion in the deep choroid in early or late hypoflurorescence) was defined as the ratio of the total area of peripapillary atrophy divided by the disc area on ICG angiography.22,24


Indocyanine green angiographic features of myopic subfoveal choroidal neovascularization as a prognostic factor after photodynamic therapy.

Byeon SH, Kwon OW, Lee SC, Kim SS, Koh HJ - Korean J Ophthalmol (2006)

ICG angiography of the right eye of a 58-year-old woman. At initial examination, the patient's best-corrected visual acuity was 20/63. The refractive error was -11.0 diopters. (3A) The mid-phase ICG angiography showed the lesion to be slightly more hyperfluorescent than the background. (3B) The late phase revealed dye leakage beyond the previous lesion with multiple lacquer cracks. (3C, 3D) At a 12-month follow-up, the patient's visual acuity had decreased to 20/200. The ICG angiography showed a similar appearance of the baseline ICG angiography despite four treatments of PDT during the previous 12 months. (3E, 3F) At the 24-month follow-up, the patient's visual acuity had returned to 20/125. During the 24-month follow-up, she had undergone PDT five times.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908812&req=5

Figure 3: ICG angiography of the right eye of a 58-year-old woman. At initial examination, the patient's best-corrected visual acuity was 20/63. The refractive error was -11.0 diopters. (3A) The mid-phase ICG angiography showed the lesion to be slightly more hyperfluorescent than the background. (3B) The late phase revealed dye leakage beyond the previous lesion with multiple lacquer cracks. (3C, 3D) At a 12-month follow-up, the patient's visual acuity had decreased to 20/200. The ICG angiography showed a similar appearance of the baseline ICG angiography despite four treatments of PDT during the previous 12 months. (3E, 3F) At the 24-month follow-up, the patient's visual acuity had returned to 20/125. During the 24-month follow-up, she had undergone PDT five times.
Mentions: Indocyanine green (ICG) angiography was performed with a scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Dossenheim, Germany). The ICG angiograms were reviewed by two examiners (SH Byeon and HJ Koh) to determine the lesion size on ICG angiography 「ratio of the total area of the lesion divided by the area of the optic disc (DA=Disc Area)」 and any associated findings, including hypofluorescence surrounding the CNV (dark rim), lacquer cracks, prominent large choroidal veins in the macula, and peripapillary choroidal atrophy size.21-24 The presence of an ICG angiographic dark rim (hypofluorescence around the CNV) was defined as a round-shaped background hypofluorescence within which a hyperfluorescent island appeared during the early phase (Fig. 1, 2).15-18 Lacquer cracks were identified using late-phase ICG angiography (Figures 1 and 3).16,22 Regarding the presence of visible large choroidal veins under the macula, the focal dilation of the choroidal veins in the posterior fundus during the early phase of ICG angiography was defined; some showed hyperfluorescence until the late-phase of the angiogram (Fig. 2).16,23 The area of peripapillary atrophy (islands of non-perfusion or reduced perfusion in the deep choroid in early or late hypoflurorescence) was defined as the ratio of the total area of peripapillary atrophy divided by the disc area on ICG angiography.22,24

Bottom Line: At one-year follow-up after PDT, a younger age (p = 0.002) and the presence of a dark rim (p = 0.002) were significantly correlated with an improvement of visual acuity (decrement in logMAR) after PDT.Other factors had no significant influence on changes in visual acuity.Younger patients and patients with a dark rim on ICG angiography had a higher chance of visual improvement after PDT in myopic CNV.

View Article: PubMed Central - PubMed

Affiliation: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To determine the influence of clinical features and Indocyanine green (ICG) angiographic features on the visual outcome of patients with myopic sub-foveal choroidal neovascularization (CNV) who received photodynamic therapy (PDT).

Methods: Thirty-six consecutive patients (39 eyes) with myopic CNV who were followed up for more than one year after PDT were enrolled in this study. Clinical features included age, gender, refractive error, great linear dimension, and subretinal hemorrhage. ICG features included the lesion size, lacquer cracks, hypofluorescence surrounding the CNV (dark rim), peripapillary atrophy size, and visible prominent choroidal veins under the macula. Linear regression analysis was performed using the change in visual acuity (delta logMAR) as the dependent variable and the above factors as independent variables.

Results: At one-year follow-up after PDT, a younger age (p = 0.002) and the presence of a dark rim (p = 0.002) were significantly correlated with an improvement of visual acuity (decrement in logMAR) after PDT. Other factors had no significant influence on changes in visual acuity.

Conclusions: Younger patients and patients with a dark rim on ICG angiography had a higher chance of visual improvement after PDT in myopic CNV.

Show MeSH
Related in: MedlinePlus