Ulrike Schneider

Retinal pigment epithelial tear after photodynamic therapy for choroidal neovascularization

PURPOSE To report a case of retinal pigment epithelial tear after photodynamic therapy for choroidal neovascularization. METHODS Case report. A 74-year-old woman with exudative age-related macular degeneration and classic subfoveal choroidal neovascularization RE underwent photodynamic therapy with verteporfin. RESULTS Ophthalmoscopy and fluorescein angiography RE disclosed a retinal pigment epithelial tear in the area of photodynamic therapy. CONCLUSION This case presents the first report of a retinal pigment epithelial tear after photodynamic therapy with verteporfin for subfoveal choroidal neovascularization in age-related macular degeneration.

DIAGNOSIS OF OCCULT SUBRETINAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION BY INFRARED SCANNING LASER VIDEOANGIOGRAPHY

Abstract: 180 consecutive patients with exudative age-related macular degeneration and clinical signs of subretinal neovascular membranes were examined by scanning laser fluorescein angiography. This technique demonstrated well-defined, newly formed subretinal vessels in approximately 50%, ill-defined subretinal vessels in approximately 20%, and not visible or occult subretinal vessels in the remaining 30% of the patients. Patients with ill-defined or occult neovascular membranes were also examined with scanning laser infrared angiography with cardiogreen. Newly formed subretinal vessels were well defined in approximately 40% of these patients, and ill defined in 23%. In 37% of the patients, neovascularizations were also not visible with infrared angiography. Results of scanning laser infrared angiography seem to be superior to earlier methods of infrared angiography. Conditions are discussed under which fluorescein and cardiogreen angiography can demonstrate subretinal membranes in age-related maculopathy.

Indocyanine Green Angiography in Classic Choroidal Neovascularization

The indocyanine green (ICG) angiographic features of classic choroidal neovascularization (CNV) were evaluated in the 66 consecutive patients (70 eyes) by ICG angiography using the scanning laser ophthalmoscope. All patients had classic CNV documented by fluorescein angiography. Indocyanine green angiographic findings of classic CNV were as follows: Vessel architecture in 66% (46 of 70) of eyes, feeding vessels in 29% (20 of 70), and late hyperfluorescence in 93% (65 of 70) of eyes. Borders of classic CNV were found well-defined in 47% (33 of 70), and ill-defined in 49% (34 of 70) of eyes. In the remaining 4% (3 of 70) of eyes ICG angiography did not detect CNV. Our study indicates that fluorescein angiography remains the method of choice in the diagnosis of classic CNV. Indocyanine green angiography provides more information in the detection of feeding vessels of classic CNV.

Detection of choroidal aneurysms with indocyanine green videoangiography

Abstract • Background: Aneurysms of the choroidal vasculature have been described only in histopathological studies. • Methods: Indocyanine green videoangiograms obtained with the scanning laser ophthalmoscope from 32 patients with geographic atrophy were reviewed. • Results: In 8 of 32 patients indocyanine green videoangiography (ICGVA) showed hyperfluorescent aneurysms along choroidal arteries. The same aneurysmal formations were found in two of the eight patients on very early images of fluorescein videoangiography before dye leakage occurred. Seven of eight patients with choroidal aneurysms had a history of hypertension. • Conclusions: ICGVA is a useful diagnostic tool in detecting choroidal aneurysms. Multiple mechanisms are probably involved in the pathogenesis of choroidal aneurysms, among them the higher hemodynamic stress in the macular region, hypertension and aging.

Infrared imaging of choroidal neovascularization by scanning laser ophthalmoscope

Infrared (IR) light penetrates deeper into the fundus and provides some information about subretinal structures. Recent advances made IR imaging with a scanning laser ophthalmoscope (SLO) possible. We performed IR ophthalmoscopy using a SLO in classic choroidal neovascularization (CNV) to determine the role of this technique in clinical use.