Indocyanine green and fluorescein angiography of surgically excised macular choroidal neovascularizations: correlations with histopathologic and ultrastructural findings

Abstract

Fluorescein and ICG angiographic differences in the appearance of CNMs could depend on (a) the morphological structure and size of the CNM (b) its location within the chorioretinal layers and (c) different molecular characteristics of the dyes used.

Indocyanine green angiographic features prognostic of visual outcome in the natural course of patients with age related macular degeneration

“…Eyes with type 4 CNV in the present study had subretinal fibrous tissue, which was similar to the ICG appearance reported by Chang et al  5 and Trabucchi et al 6. This type of CNV reportedly showed fibrous reaction, and Trabucchi et al demonstrated that the endothelium of the new vessels had a non-leaking morphology, with tight intercellular junctions and no fenestration.…”

“…Chang et al  5 demonstrated that subretinal pigment epithelial CNV showed late, well demarcated hyperfluorescence with little dye leakage on ICG angiography, and suggested that this type of lesion was clinically inactive and did not cause severe visual acuity loss. Chang et al  5 and Trabucchi et al  6 reported that subretinal fibrous scars showed early hypofluorescence and late, poorly delineated areas, or late staining of the proliferative tissue on ICG angiography. Nakajima et al  7 classified CNV into four types on the basis of ICG angiography (type 1, hyperfluorescence in both the early and late phase; type 2, hyperfluorescence only in the early phase; type 3, hyperfluorescence in the late phase; type 4, virtually no hyperfluorescence in any phase), and examined histological features of surgically removed CNV.…”

Subretinal fibrosis and choroidal neovascularization in Vogt-Koyanagi-Harada syndrome

“…Histologic examination of choroidal neovascular membranes showed that 'scar-evolved' membranes had a thicker fibrovascular structure, with a lower cell density and fewer vascular channels, than well-defined younger membranes [32]. On the other hand, subretinal fibrosis resulting from a chronic exudative retinal detachment consists of mainly modified retinal pigment epithelia.…”

A new kind of labyrinth-like capillary is responsible for leakage from human choroidal neovascular endothelium, as investigated by high-resolution electron microscopy

“…Searching for vessel leakage needs high local resolution, and can therefore be best performed by electron microscopy. A comparison of histology with indocyanine-green angiography, as used in patient care, was not performed, as it is difficult to compare ICG angiography with histopathological findings of surgically excised CNVs of AMD patients as shown by Trabucchi et al [22]. The authors are unaware of any previous histopathological reports at an ultrastructural level investigating the cell connections between neovascular endothelial cells or the frequency of fenestrations in neovascular blood vessels in human CNV treated by anti-VEGF therapy.…”