Polypoidal choroidal vasculopathy and late geographic hyperfluorescence on indocyanine green angiography

Kang, Se Woong; Chung, Song Ee; Shin, Woo Jae; Lee, Junghye

doi:10.1136/bjo.2008.145862

Cited by 42 publications

(26 citation statements)

References 25 publications

(26 reference statements)

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“…Observations of the corresponding uniform hyperfluorescent area within the late staining pattern (LGH) 15 in the area of the fine vascular network may indicate a relative leakiness of these crowded vessels, On the other hand, the LGH tended to become more obscure after the regression of the fine vascular network. However, the LGH was not detected as frequently in our eyes as Kang et al reported.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, reducing the number of recurrences is an important aspect of the treatment of PCV. 13,14 Although there is no established way to predict recurrences, the indocyanine green angiographic (IA) findings seemed to offer some clues as was suggested by Kang et al 15 They investigated the staining pattern in late phase IA images and found a late geographic hyperfluorescent (LGH) pattern, which matched the total area of the branching network and polyps. They found that a persistence of the LGH pattern was associated with the recurrence of the polypoidal lesions.…”

Section: Introductionmentioning

confidence: 99%

“…They found that a persistence of the LGH pattern was associated with the recurrence of the polypoidal lesions. 15 To further explore the characteristic IA findings associated with the vascular pattern in eyes with PCV, and to determine whether the pattern had a predictive value on recurrences, we reviewed the early to middle phase IA images of eyes with PCV that had undergone PDT. In the middle phase IA images (1-1.5 min) before treatment, the PCV vascular network contained an area that consisted mainly of fine and densely packed vessels, and individual vessels were difficult to detect.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Oishi

Mandai

Kimakura

et al. 2011

Eye

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Objective To characterize an irregular capillary-like structure in the vascular network of eyes with polypoidal choroidal vasculopathy (PCV), and to determine whether its presence after photodynamic therapy (PDT) can be used to predict the clinical course of PCV. Methods We reviewed the clinical records of 29 eyes of 29 patients with PCV, who underwent PDT and confocal retinal angiographic examinations every 3 months. The images obtained before the PDT were compared with those after the PDT. The correlations between angiography findings and recurrences were evaluated. Results An area of fine, densely packed capillary-like vessels, named the fine vascular network, was identified within the polypoidal vascular network in 25 of 29 cases at the initial examination. The fine vascular network regressed in 23 cases (92%) after the first PDT. Thereafter, the fine vascular network remained or enlarged in 19 eyes, and 17 (84.5%) of these eyes had a recurrence of the polypoidal lesions or had exudative changes. In contrast, recurrences were found in only 2 of 10 (20%) eyes, whose fine network had regressed without a subsequent enlargement (Po0.001 compared with the former group). Conclusions A fine irregular vascular network is present in the majority of eyes with PCV before PDT. Its presence or expansion after PDT was significantly associated with a recurrence of PCV. Thus, we recommend that this network be monitored after treatment to determine whether a polypoidal vascular network will recur.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Oishi

Mandai

Kimakura

et al. 2011

Eye

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“…When ICGA could not be used for a definitive diagnosis owing to the presence of extensive subretinal hemorrhage, ICGA images obtained within 6 months of the initial diagnosis were reviewed. In some cases, the presence of late geographic hyperfluorescence on ICGA 17,18 and/or the doublelayer sign on optical coherence tomography (OCT) 18,19 was observed in association with a branching vascular network on ICGA. These cases were diagnosed as PCV, although no definite polypoidal lesion was identified.…”

Section: Introductionmentioning

confidence: 97%

Treatment Outcomes in Eyes with Polypoidal Choroidal Vasculopathy with Poor Baseline Visual Acuity

Kim

Kim²,

Lee³

et al. 2015

Journal of Ocular Pharmacology and Therapeutics

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“…5 Other features of PCV may include branching vascular network (BVN), pulsatile polyp, presence of hypofluorescent halo, and late phase hyperfluorescent plaque. 4,6,7 The location and size of polyps in ICGA are important features for surgeons to decide the area of thermal laser application or photodynamic therapy (PDT) because of the higher regression rate of polyps by PDT comparing with monotherapy with antivascular endothelial growth factor (anti-VEGF). 6 However, diagnosis of polyps in ICGA remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

Automatic Segmentation of Polypoidal Choroidal Vasculopathy from Indocyanine Green Angiography Using Spatial and Temporal Patterns

Lin

Yang

Chen

et al. 2015

Trans. Vis. Sci. Tech.

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Citation: Lin WY, Yang SC, Chen SJ, Tsai CL, Du SZ, Lim TH. Automatic segmentation of polypoidal choroidal vasculopathy from idocyanine green angiography using spatial and temporal patterns. Tran Vis Sci Tech. 2015;4(2):7, http://tvstjournal.org/ doi/full/10.1167/tvst. 4.2.7, doi: 10.1167/tvst.4.2.7 Purpose: To develop a computer-aided diagnostic tool for automated detection and quantification of polypoidal regions in indocyanine green angiography (ICGA) images. Methods:The ICGA sequences of 59 polypoidal choroidal vasculopathy (PCV) treatment-naïve patients from five Asian countries (Hong Kong, Singapore, South Korea, Taiwan, and Thailand) were provided by the EVEREST study. The ground truth was provided by the reading center for the presence of polypoidal regions. The proposed detection algorithm used both temporal and spatial features to characterize the severity of polypoidal lesions in ICGA sequences. Leave-one-out cross validation was carried out so that each patient was used once as the validation sample. For each patient, a fixed detection threshold of 0.5 on the severity was applied to obtain sensitivity, specificity, and balanced accuracy with respect to the ground truth.Results: Our system achieved an average accuracy of 0.9126 (sensitivity ¼ 0.9125, specificity ¼ 0.9127) for detection of polyps in the 59 ICGA sequences. Among the total of 222 features extracted from ICGA sequence, the spatial variances exhibited best discriminative power in distinguishing between polyp and nonpolyp regions. The results also indicated the importance of combining spatial and temporal features to further improve detection accuracy. Conclusions:The developed software provided a means of detecting and quantifying polypoidal regions in ICGA images for the first time.Translational Relevance: This preliminary study demonstrated a computer-aided diagnostic tool, which enables objective evaluation of PCV and its progression. Ophthalmologists can easily visualize the polypoidal regions and obtain quantitative information about polyps by using the proposed system.

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Polypoidal choroidal vasculopathy and late geographic hyperfluorescence on indocyanine green angiography

Abstract: LGH is a highly sensitive and specific ICGA finding for the diagnosis of PCV. Increased surveillance should be implemented in eyes in which LGH persists after PDT.

Cited by 42 publications

References 25 publications

Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Treatment Outcomes in Eyes with Polypoidal Choroidal Vasculopathy with Poor Baseline Visual Acuity

Automatic Segmentation of Polypoidal Choroidal Vasculopathy from Indocyanine Green Angiography Using Spatial and Temporal Patterns

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