Imaging of Chorioretinal Anastomoses in Vascularized Retinal Pigment Epithelium Detachments

doi:10.1001/archopht.1995.01100110052025

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Vol. 113 No. 11, November 1995

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Imaging of Chorioretinal Anastomoses in Vascularized Retinal Pigment Epithelium Detachments

Dagmar Kuhn, MD; Isabelle Meunier, MD; Gisèle Soubrane, MD, PhD; Gabriel Coscas, MD

Arch Ophthalmol. 1995;113(11):1392-1398.

Abstract

Objective
To identify specific features of pigment epithelium detachmentswith limited hyperfluorescent lesions (hot spots).

Design
One hundred eighty-two consecutive patients (186 eyes) who hadvascularized pigment epithelium detachments and recent onsetof symptoms were examined with indocyanine green and fluoresceinvideoangiography using the scanning laser ophthalmoscope. Thechoroidal neovascularization complex and macular retinal vesselswere studied. The natural history and the effect of laser treatmentwere evaluated.

Results
Fifty-four eyes had hot spots on indocyanine green angiography.In 50 of these 54 eyes, the video analysis showed an anastomosisof one or more retinal vessels, with the choroidal neovascularizationwithin the hot spot. One or two retinal veins or arteries orboth filled with both dyes and were seen to enter into the hotspot. Results of indocyanine green-guided photocoagulation ofthe hot spot in 28 eyes were disappointing.

Conclusion
Continuous recording of the early phases of fluorescein andindocyanine green angiography allowed identification of chorioretinalanastomoses in vascularized pigment epithelium detachments withhot spots at an early exudative stage of age-related maculardegeneration in 50 (26.8%) of 186 eyes. The poor outcome oflaser photocoagulation for choroidal neovascularization in thissetting could be related not only to the development of an overlyingpigment epithelium detachment, but also to the retinal and choroidalvascularization of the lesion.

Author Affiliations

From the Department of Ophthalmology of University Paris-XII—Créteil (France).

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