Simultaneous Fluorescein and Indocyanine Green Angiography for Exudative Macular Degeneration

Background: The present study investigates how often a simultaneous fluorescein and indocyanine green (ICG) angiography had therapeutic consequences and if it is useful as a clinical routine diagnostic tool. Patients and methods: 502 consecutive simultaneous angiographies in eyes with exudative macular degeneration were retrospectively studied. Results: A classic extra- or juxtafoveolar choroidal neovascularisation (CNV) was found in 3.5% of the eyes. A subfoveal predominantly classic CNV was present in 19% of the angiographies. ICG angiography showed a vascular network in 3 % of the eyes with occult CNV in fluorescein angiography. A neovascularisation supplied by retinal vessels (retinal angiomatous proliferation) was found in 9% and a polypoidal choroidal vasculopathy (PCV) in 6%. Other plaques or hot spots were visible in 4%. In 11 eyes with progressive exudation from PCV and threatening of the fovea, laser treatment was successfully performed. Conclusions: Combined angiography identifies treatable PCV. Advantages of a combined procedure (easier logistics, no missing of treatable cases) and arguments for a two step procedure with ICG angiography only in selected cases (lower costs, lower rate of adverse reactions) must be weighed against each other.