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Invest Ophthalmol Vis Sci. 2007 Apr;48(4):1751-60.

Three-dimensional angiography of classic and occult lesion types in choroidal neovascularization.

Author information

  • 1Department of Ophthalmology, Vienna University, Währinger Gürtel 18-20, 1090 Vienna, Austria. ursula.schmidt-erfurth@meduniwien.ac.at

Abstract

PURPOSE:

To identify characteristic features of classic and occult choroidal neovascularization (CNV) by using a novel technique of topographic angiography for three-dimensional (3D) visualization.

METHODS:

A confocal scanning laser ophthalmoscope (SLO, Heidelberg Retina Angiograph; Heidelberg Engineering, Dossenheim, Germany) was used to perform fluorescein (FA) and indocyanine green (ICGA) angiography in158 patients. Ninety-four eyes had predominantly classic and 64 eyes had occult lesions. With an image frequency of 20 Hz, a tomographic series of 32 images per set were taken over a depth of 4 mm. Axial analyses for each x/year position were performed, to determine the fluorescence distribution along the z-axis. After the axial location of hyperfluorescence was detected, a depth profile was generated. All results were integrated into a gray-scale-coded depth image and imaged as a 3D relief.

RESULTS:

Characteristic features of classic and occult lesions were distinguished. Classic CNV appeared as a well-demarcated lesion with steep, prominent borders, often craterlike, and frequently surrounded by a halo, suggesting choroidal perfusion changes. Occult CNV was documented by 3D as a convex lesion with flat, ill-defined borders and without any surrounding halo. Topographic imaging is superior to conventional angiography regarding definition of lesion type, configuration, and extension, because masking phenomena do not interfere.

CONCLUSIONS:

Topographic angiography allows a realistic 3D representation of CNV. Characteristic features based on the neovascular architecture and the differences in leakage behavior of different lesion types are clearly identified.

PMID:
17389508
DOI:
10.1167/iovs.06-0686
[PubMed - indexed for MEDLINE]
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