Hypofluorescent spots in indocyanine green angiography of peau d'orange and fundus.

Abstract

Hypofluorescent spots were seen in indocyanine green (ICG) angiography of peau d'orange fundus in eyes with angioid streaks. Origin of the hypofluorescent spots were examined with attention to their correlation with a peau d'orange appearance of the central fundus using a computer-assisted image comparison system. ICG angiography was performed in 5 patients having peau d'orange appearance of fundus using a scanning laser ophthalmoscope (SLO) and a digital video-fundus camera. The same central fundus areas corresponding to hypofluorescent spots in an ICG angiogram were then digitally identified in a fluorescein angiogram and in a red-free picture in all 10 eyes of the 5 patients. Monochromatic light observation was also performed with a dark field observation using an SLO to see subretinal or intrachoroidal pigment clumping. In no patient, the areas identified with hypofluorescent spots did show relevant changes in fluorescein angiogram or red-free picture. SLO examination revealed no perfusion defect at the same areas. The dark field observation showed no pigment clumping at the peripapillary and papillomacular bundle regions where hypofluorescent spots were seen. Hypofluorescent spots seen in ICG angiograms did not show exact consistency with peau d'orange changes in their location and shape. Perfusion defects or blocking by pigments were not a cause of hypofluorescent spots. The scattered hypofluorescent spots were considered to be relevant with irregular affinity of the fundus to ICG dye.