Indocyanine Green Angiography in High Myopia

Abstract

To evaluate indocyanine green imaging of choroidal changes in pathologic myopia and to compare it with fluorescein angiography. The angiograms of all consecutive patients with pathologic myopia photographed with confocal indocyanine green angiography using a scanning infrared laser or ophthalmoscope from March 1997 to December 1999 were reviewed. Twenty-one patients (35 eyes) were included. Indocyanine green angiography was performed in 35 eyes and immediate sequential fluorescein angiography and indocyanine green angiography in 25 eyes. The lacquer cracks were demonstrated to radiate from the disc, at the papillomacular bundle, through the macula, and around the macula. Lacquer cracks were identified in 89% and 28% of the eyes, respectively. Choroidal neovascularization (CNV) was demonstrated in 57% of eyes by indocyanine green angiography and in 56% by fluorescein angiography. All of the CNVs were classic and were located within 300 microm of the foveal center. Seventy percent of the CNVs were delineated in lacquer cracks by indocyanine green angiography. Overall, 124 lacquer cracks were identified by indocyanine green angiography and only 14 by fluorescein angiography. Lipids or serous detachment were not observed. Retinal hemorrhages were noted in 22% and 28% of eyes with indocyanine green angiography and fluorescein angiography, respectively. Confocal indocyanine green angiography offers better delineation of lacquer cracks and the localization of the CNV in lacquer cracks than does fluorescein angiography.