Indocyanine green videoangiography after acute retinal pigment epithelial tears in age-related macular degeneration.

PURPOSE

To determine the features of combined fluorescein and indocyanine green videoangiography after acute retinal pigment epithelial tears associated with age-related macular degeneration.

METHODS

We performed combined fluorescein and indocyanine green videoangiography in three eyes of three patients 2 days to 2 months after the development of tears of the retinal pigment epithelium.

RESULTS

The area of exposed choroid in a retinal pigment epithelial tear shows intense hyperfluorescence in fluorescein videoangiography; in contrast, this area demonstrates near-normal choroidal fluorescence on an indocyanine green videoangiogram. The folded and retracted flap of retinal pigment epithelium in a retinal pigment epithelial tear discloses marked hypofluorescence on the fluorescein videoangiogram; in contrast, this flap of retinal pigment epithelium displays varying degrees of hyperfluorescence on the indocyanine green videoangiogram.

CONCLUSIONS

The angiographic differences between fluorescein and indocyanine green result from the distinct biophysical properties of these two dyes as well as from the differential penetration of their fluorescence through such pigmented structures as retinal pigment epithelium. Compared with fluorescein videoangiography, indocyanine green videoangiography allows better visualization of choroidal neovascular membranes within the rolled-up and retracted flap of the retinal pigment epithelial tear.