Indocyanine green angiographic findings of Dalen-Fuchs nodules in Vogt-Koyanagi-Harada disease.

PURPOSE: The purpose of this study was to analyze indocyanine green (ICG) angiographic findings of Dalen-Fuchs nodules in Vogt-Koyanagi-Harada (VKH) disease. METHODS: ICG angiograms of 15 patients (30 eyes) with Dalen-Fuchs nodules in VKH disease of between 2 months and 5 years after the initial diagnosis were retrospectively studied. Findings of ICG angiography were compared with features of fundus fluorescein angiography (FFA). RESULTS: Dalen-Fuchs nodules were easily found in the inferior (30 eyes, 100%) and temporal periphery (22 eyes, 73%) and showed two kinds of fluorescence in ICG angiography. In ten patients (20 eyes), the nodules showed small round hypofluorescent dark dots in the whole process of angiography, and the dark dots were larger in size than the nodules in FFA. Disease course in these patients was relatively long-between 1 year and 5 years. On clinical examination, the nodules were atrophic, and hyperpigmentation was found around them. In another five patients (ten eyes), parts of the nodules showed small hyperfluorescent dots in the early phase, but they were faint in the intermediate phase and became large, hypofluorescent dark dots in the late phase. Disease course in these patients was between 2 and 8 months. The nodules were bright yellow, fresh, and much larger than those in the first kind of ICG fluorescence. CONCLUSIONS: Dalen-Fuchs nodules in VKH are mostly present in the inferior and temporal periphery. The two kinds of fluorescence of Dalen-Fuchs in ICG angiography may reflect obliteration of choriocapillaris under the nodules and different quantities of lipofuscin in the nodules at different time points of the disease.     

眼底血管样条纹临床及荧光造影表现

目的 分析眼底血管样条纹(angioidstreaks,AS)的临床特征与眼底荧光血管造影(fundus fluorescein angiography,FFA)及吲哚青绿血管造影(fundus indocyanine green Angiography,ICG)表现.方法 对7例(14只眼)血管样条纹患者行眼科常规检查,眼底照相.其中6例(12只眼)患者行FFA及ICG检查.结果 眼底表现:14只眼眼底见视盘周围血管样放射状条纹,7只眼黄斑区视网膜下出血,黄白色硬性渗出,大小不一的灰黄色病灶(50.00%),3只眼见黄斑区萎缩瘢痕灶(21.43%);FFA表现:血管样条纹10眼表现为透见荧光(83.33%),2只眼表现为中央低荧光,两侧高荧光(16.67%),7只眼在黄斑区出现脉络膜新生血管(choroidalneovascularization,CNV)的强荧光(58.33%),3只眼黄斑区萎缩瘢痕灶晚期荧光着染(25.00%);ICG表现:12只眼血管样条纹表现为早期不显影,中期呈强荧光,7只眼CNV表现为强荧光,3只眼黄斑区萎缩瘢痕灶中2只眼见边界不清斑状CNV.结论 眼底血管样条纹患者的眼底较典型,FFA及ICG能进一步明确诊断,对疾病治疗有指导意义.

Abstract：

Objective To investigate the clinical manifestations, features of fundus fluorescein angiography(FFA)and fundus indocyanine green angiography(ICG)with angioid streaks. Methods Seven patients(14 eyes)with bilateral angioid streaks were examined by the routine ophthalmological examination, FFA and ICG. Colorfundus photographs were also taken. Results Fundus findings: angioid streaks were visualized in the posterior pole of 14 eyes and the macular areas of 7 eyes,(50.00%)had subretinal hemorrhages with neovascularization. FFA: streaks were hyperfluorescent in 10 eyes(83.33%), hypofluorescentareas between hyperfluorescent edges in 2 of the 12 eyes(16.67%), hyperfluorescent were seen in choroidal neovascularization (CNV)of macular in 7 eyes(58.33%). ICG: the result of streaks in 12 eyes showed hypofluorescence at the early phase and hyperfluorescence at the late phase, hyperfluorescent were seen in CNV of macular in 7 eyes, 2 eyes presented occult CNV. Conclusion In all eyes, angioid streaks are well visualized. FFA and ICG results may contribute to the diagnosis and treatment for patients with angioid streaks.     

眼底血管样条纹临床及荧光造影表现

目的 分析眼底血管样条纹(angioidstreaks,AS)的临床特征与眼底荧光血管造影(fundus fluorescein angiography,FFA)及吲哚青绿血管造影(fundus indocyanine green Angiography,ICG)表现.方法 对7例(14只眼)血管样条纹患者行眼科常规检查,眼底照相.其中6例(12只眼)患者行FFA及ICG检查.结果 眼底表现:14只眼眼底见视盘周围血管样放射状条纹,7只眼黄斑区视网膜下出血,黄白色硬性渗出,大小不一的灰黄色病灶(50.00%),3只眼见黄斑区萎缩瘢痕灶(21.43%);FFA表现:血管样条纹10眼表现为透见荧光(83.33%),2只眼表现为中央低荧光,两侧高荧光(16.67%),7只眼在黄斑区出现脉络膜新生血管(choroidalneovascularization,CNV)的强荧光(58.33%),3只眼黄斑区萎缩瘢痕灶晚期荧光着染(25.00%);ICG表现:12只眼血管样条纹表现为早期不显影,中期呈强荧光,7只眼CNV表现为强荧光,3只眼黄斑区萎缩瘢痕灶中2只眼见边界不清斑状CNV.结论 眼底血管样条纹患者的眼底较典型,FFA及ICG能进一步明确诊断,对疾病治疗有指导意义.     

Silent occult choroidal vascular abnormalities

PURPOSE: To describe clinically occult choroidal vascular abnormalities that can be revealed by indocyanine green (ICG) angiography. METHODS: Out of approximately 2,700 patients who underwent ICG angiography, a lesion was incidentally observed in eight eyes of eight patients. In five patients, the ICG study included a second examination taken during artificially induced intraocular hypertension. Examinations were repeated in six patients over a follow-up period ranging from 4 months to 3 years. RESULTS: On ICG angiogram, the choroidal vasculopathy appeared as a round-oval hyperfluorescent area 2-4 disk diameters in size that was located at the temporal vascular arcades in six eyes, at the inferomacular region in one eye, and above the optic disk in one eye. The lesions were not identifiable with funduscopic, fluorescein angiographic, or ultrasonographic examination. The lesions filled at the same time as the choroidal arteries and lost fluorescence in mid-late phase of the ICG angiogram. The ICG series taken during induced intraocular hypertension showed the hyperfluorescent areas originated from choroidal arterial abnormalities giving rise to confluent hyperfluorescent patches. Draining vessels connecting the choroidal vasculopathy with a vortex vein were evidenced in three eyes. A sector of apparent choroidal hypoperfusion downstream from the lesion was present in three eyes. During the follow-up period, the lesions remained occult and with an unchanged ICG angiographic pattern in all patients. CONCLUSION: Some silent occult choroidal vascular abnormalities may be incidentally revealed by ICG angiography. These must be distinguished from ICG imaging of concomitant chorioretinal disorders.     

Choroidal vascular lesions identified by ICG angiography in a case of familial amyloidotic polyneuropathy

BACKGROUND: To describe a patient with familial amyloidotic polyneuropathy (FAP) whose choroidal vascular lesions were demonstrated dynamically with the use of indocyanine green (ICG) angiography. CASE: A 59-year-old man complained of blurred vision due to vitreal amyloidosis in both eyes. Fundus examination after pars plana vitrectomy showed multiple retinal hemorrhages. OBSERVATIONS: ICG angiography performed after vitrectomy clearly delineated multiple sites of hyperfluorescence indicating tissue staining alongside the major choroidal veins in the lower fundus of his left eye. ICG hyperfluorescence was more evident in the late angiographic phase. Fundus examination and fluorescein angiography revealed no abnormal findings at the corresponding sites of ICG dye leakage. CONCLUSIONS: Choroidal vascular lesions in eyes with FAP were demonstrated in vivo using ICG angiography for the first time. ICG angiography may be very beneficial to evaluate occult choroidal involvement in patients with FAP.     

Indocyanine green angiographic findings of Dalen-Fuchs nodules in Vogt-Koyanagi-Harada disease

Purpose The purpose of this study was to analyze indocyanine green (ICG) angiographic findings of Dalen-Fuchs nodules in Vogt-Koyanagi-Harada (VKH) disease. Methods ICG angiograms of 15 patients (30 eyes) with Dalen-Fuchs nodules in VKH disease of between 2 months and 5 years after the initial diagnosis were retrospectively studied. Findings of ICG angiography were compared with features of fundus fluorescein angiography (FFA). Results Dalen-Fuchs nodules were easily found in the inferior (30 eyes, 100%) and temporal periphery (22 eyes, 73%) and showed two kinds of fluorescence in ICG angiography. In ten patients (20 eyes), the nodules showed small round hypofluorescent dark dots in the whole process of angiography, and the dark dots were larger in size than the nodules in FFA. Disease course in these patients was relatively long—between 1 year and 5 years. On clinical examination, the nodules were atrophic, and hyperpigmentation was found around them. In another five patients (ten eyes), parts of the nodules showed small hyperfluorescent dots in the early phase, but they were faint in the intermediate phase and became large, hypofluorescent dark dots in the late phase. Disease course in these patients was between 2 and 8 months. The nodules were bright yellow, fresh, and much larger than those in the first kind of ICG fluorescence. Conclusions Dalen-Fuchs nodules in VKH are mostly present in the inferior and temporal periphery. The two kinds of fluorescence of Dalen-Fuchs in ICG angiography may reflect obliteration of choriocapillaris under the nodules and different quantities of lipofuscin in the nodules at different time points of the disease.     

The nature and frequency of neovascular age-related macular degeneration

PURPOSE: This study was designed to evaluate the frequency and nature of neovascularization in age-related macular degeneration (ARMD) utilizing the combination of digital imaging techniques, fluorescein angiography (FA), indocyanine green (ICG) angiography, and optical coherence tomography (OCT). METHODS: A complete clinical examination was performed on 100 eyes of 93 consecutive newly diagnosed patients with neovascular ARMD. Digital fluorescein angiography, ICG angiography, and OCT were also used in evaluating those patients. Comparison of the imaging techniques to determine their value in studying the nature of the lesions. RESULTS: On the basis of existing fluorescein standards, 15 eyes were diagnosed with classic choroidal neovascularization (CNV), 15 with minimally classic CNV, and 70 with occult CNV. ICG angiography was superior for detecting the active vascular component in polypoidal CNV (16 eyes) and retinal angiomatous proliferation (14 eyes). OCT was more sensitive than FA for determining the presence of cystoid macular edema evident in the vast majority of eyes with retinal angiomatous proliferation (RAP). CONCLUSIONS: These results suggest that FA, ICG angiography, and OCT, when used in combination, will assist clinicians in best determining the precise nature of the neovascular process in ARMD.     

Indocyanine green angiographic findings in Beh?et disease.

BACKGROUND: The authors studied indocyanine green (ICG) angiographic features in proven cases of ocular Beh?et disease. METHODS: Twenty-six patients (18 male, 8 female; mean age 39.9 +/- 8.9 years) with Beh?et disease underwent simultaneous ICG and fluorescein angiography (FA) according to a uveitis angiographic standard protocol. Patients were divided into three groups based on their ocular disease duration: Group A (9 patients), less than 3-year duration; Group B (8 patients), 4- to 10-year duration; Group C (9 patients), more than 10-year duration. The relation between ICG angiographic findings and ocular disease duration and FA signs was delimited. RESULTS: Three findings were disclosed by ICG angiography: 1) poorly defined areas of intermediate and late hyperfluorescence (50% of eyes); 2) well-defined hypofluorescent areas becoming isofluorescent in the late phase (26.92% of eyes); and 3) large, poorly defined hypofluorescent areas visible up to the late phase (30.77% of eyes). The presence of ICG hypofluorescent areas up to the late phase was related to disease duration (P = 0.01), whereas ICG hypofluorescent areas becoming isofluorescent in the late phase were predominant in patients in early stages of ocular disease (P = 0.02). The presence or absence of FA signs did not indicate any significant correlation with the presence or absence of signs revealed by ICG angiography. CONCLUSION: Indocyanine green angiography enabled the identification of different choroidal abnormalities related to the ocular disease duration. The presence of some ICG findings undetectable with FA suggests that ICG and FA are complementary means to diagnose and monitor ocular vascular involvement in patients with Beh?et disease.     

Indocyanine green angiographic findings of chorioretinal folds

PURPOSE: To analyze indocyanine green (ICG) angiographic findings of chorioretinal folds. METHODS: Eight patients (9 eyes) in whom chorioretinal folds had been diagnosed were enrolled in this study. Color photography, fluorescein angiography (FA) and ICG angiography (IA) were performed. RESULTS: Indocyanine green angiography demonstrated choroidal venous congestion and a filling delay of the choroidal vessels in one case with an orbital tumor. In one posterior scleritis case, IA showed a filling delay of choroidal vessels in the early phase and multiple patchy hypofluorescent lesions scattered in the posterior pole during the late phase. Idiopathic cases showed choroidal venous dilatation. No abnormalities of the choroidal vasculature in the form of radial folds, were revealed in two cases of AMD. Linear hyperfluorescent areas suggestive of chorioretinal folds seen on IA were less numerous and wider than those observed on FA in some eyes. On the other hand, they were equally numerous and wider on IA than those on FA in other eyes. CONCLUSION: Indocyanine green angiography is useful for evaluating both pathological conditions of the choroidal vasculature and the width of chorioretinal folds at the level of the choroidal vasculature.     

Rapid injection of indocyanine green dye for evaluation of choroidal venous circulation

PURPOSE: The purpose of this study was to investigate the effects of rapid intravenous administration of a small bolus of indocyanine green (ICG) dye on early phase findings of ICG angiography. METHODS: Rabbit eyes were used. Ten normal eyes, 5 eyes with occlusion of vortex veins, and 5 eyes with chorioretinal atrophy were examined by ICG angiography, and early-phase findings after a rapid injection of a small bolus of dye were compared with those obtained with an ordinary injection. RESULTS: In normal eyes, after the rapid injection it was possible to visualize some small bright fluorescent boluses in the choroidal veins from 6 to 12 seconds after injection, while with the ordinary injection they were unclear. In eyes with occlusion of vortex veins, the rapid injection resulted in visualization of the choroidal veins with delayed filling against the background, and the region of the choroidal veins with delayed filling could easily be determined. In eyes with chorioretinal atrophy, only the rapid injection clearly revealed the choroidal veins with delayed filling. CONCLUSIONS: The rapid injection made it possible to detect the choroidal veins with delayed filling that were not clearly and easily visible using an ordinary injection. Rapid injection of ICG dye is useful for a detailed examination of choroidal circulation.     

Indocyanine green angiographic findings for patients with systemic lupus erythematosus nephropathy

PURPOSE: To study indocyanine green (ICG) angiographic findings for patients with systemic lupus erythematosus (SLE) nephropathy. In particular, the presence of choroidal abnormalities at ICG angiography, which could not be detected by fluorescein angiography, was studied. DESIGN: Observational case report study. METHODS: Nine consecutive female patients (mean age +/- SD, 38.2 +/- 9.7 years) with SLE-related nephropathy underwent simultaneous ICG angiography and fluorescein angiography according to a standard angiographic protocol for uveitis. RESULTS: Two findings were revealed by ICG angiography: focal, transient hypofluorescent areas in the early phase; and spots of choroidal hyperfluorescence visible from the intermediate to late phase. CONCLUSIONS: ICG angiography can provide information that is not detectable by clinical or fluorescein angiographic examination for patients with lupus nephropathy. This information may prove useful in better understanding the pathogenesis of SLE choroidopathy.     

Comparison of indocyanine green and fluorescein angiography of choroidal neovascularization

We compared indocyanine green (ICG) and fluorescein angiography for evaluation of choroidal neovascularization (CNV). Cast preparations of CNV induced in monkey eyes by laser photocoagulation were correlated with ICG and fluorescein angiographies of the same CNV formations. Fluorescein angiography was more effective, in general, than ICG angiography in detecting CNV; however, CNVs with subretinal hemorrhage (2 of 35 sites) were visible only with ICG angiography. In early phase ICG angiography, CNV formations that casts showed to be dense or composed of thick vessels were seen, but less dense areas were not visible. Lesions that ICG angiography revealed as leaking were not differentiated morphologically from non-leaking areas by the CNV casts. This study confirms that only ICG angiography can identify CNV hidden by subretinal hemorrhage, although fluorescein angiography is otherwise superior. Indocyanine green angiography is indicated as a valuable complement to fluorescein angiography for evaluation of CNV.     

Indocyanine green angiography in patients with human T cell-lymphotropic virus type 1 uveitis

PURPOSE: To determine the indocyanine green (ICG) angiographic features and to evaluate the choroidal involvement of human T-cell lymphotropic virus type 1 (HTLV-1)-associated uveitis. METHODS: We performed ICG angiography using scanning laser ophthalmoscopy in 54 eyes of 27 patients (8 men and 19 women) diagnosed with HTLV-1 uveitis. The patient's mean age was 51.5 years with a range of 24-65 years. RESULTS: The early phase of ICG angiography revealed ICG leakage from the choroidal vessels in the posterior pole, hyperfluorescent spots that which were not detected with fluorescein angiography, and small hypofluorescent lesions in the macula which most likely corresponded to microcirculatory disturbances in the choriocapillaris. CONCLUSIONS: We suggest that the ICG angiographic findings reflect choroidal lesions such as infiltration with leukocytes and edema. ICG angiography may provide useful information on choroidopathy in HTLV-1 uveitis.     

The use of indocyanine green angiography in diagnosis of occult choroidal neovascularization in age-related macular degeneration

PURPOSE: To determine whether scanning laser ophthalmoscopy (SLO) indocyanine green (ICG) angiography may be useful in detecting occult or ill-defined choroidal neovascularization (CNV). MATERIAL AND METHODS: ICG angiography using SLO was performed in 28 patients (29 eyes). Indication for this examination was occult or ill-defined CNV on fluorescein angiography. RESULTS: Well-defined hyperfluorescent lesions on ICG angiography were found in 16 eyes (55.2%). Three morphological types of CNV were noted: plaque (82.8%), focal spots (10.4%), combination lesions (3.4%). In one case no manifestations of CNV were observed in ICG angiography (3.4%). In 4 eyes (13.8%) we performed successful laseroterapy of CNV. CONCLUSIONS: ICG angiography performed using SLO is a valuable tool in determining borders of occult and ill-defined CNV.     

Knobby-like choroidal neovascularization accompanied with retinal pigment epithelial detachment]

PURPOSE: To evaluate the clinical features of knobby choroidal neovascularization (CNV) which was detected using indocyanine green (ICG) angiography and the association between knobby CNV and idiopathic polypoidal choroidal vasculopathy (IPCV). METHOD: We studied 164 eyes with retinal pigment epithelial detachment (PED) accompanied with CNV. These patients were older than 50 years. We detected knobby CNV in 96 eyes of 164 PED eyes (58.5%). Knobby CNV was defined as follows: knobbed blood vessels were observed from the early phase and remained hyperfluorescent through the ICG angiography. We classified 3 groups on the basis of the types of vessels with knobby CNV: group I, multiple isolated knobby CNVs without continuous vessels (24 eyes); group II, knobby dilatations in some parts of CNV (45 eyes); group III, network vessels ending in multiple aneurysmal swelling as in IPCV (27 eyes). RESULT: We found knobby CNV in only 20% of eyes with serous PED, but about 70% in neovascular, serosanguineous, and hemorrhagic PED. The ratio of each group showed no distinction statistically. Knobby CNV mostly appeared in macular areas, and was frequently accompanied with subretinal or subpigment epithelial hemorrhage. Subretinal reddishorange lesions were seen in 50% of group I, 60% of group II, and 89% of group III. Knobby CNV showed occult CNV in fluorescein angiography. In late phase ICG angiography, knobby CNV leaked ICG. New lesions occurred in all groups. CONCLUSION: We think that knobby CNV is a common finding in subpigment epithelial neovascularization, and that IPCV vascular lesion is one type of subpigment epithelial neovascularization.     

Selective photodynamic therapy for neovascular age-related macular degeneration with polypoidal choroidal neovascularization

PURPOSE: To evaluate the efficacy of selective treatment with indocyanine green (ICG) angiography-guided photodynamic therapy (PDT) with verteporfin for polypoidal choroidal vasculopathy (PCV). METHODS: In this retrospective consecutive series, 30 eyes of 30 patients with PCV were included. Complete ocular examination, digital fluorescein angiography (FA), ICG angiography, and optical coherence tomography were performed at baseline and at standard intervals thereafter. ICG angiography-guided PDT was performed on all eyes. Only the area of the active PCV or "hot spot" evident on the ICG angiogram was treated. A spot size was chosen to cover the active neovascular lesion with a 200-mum border. Retreatment was performed when angiography revealed a recurrent lesion. RESULTS: Thirty eyes with PCV were treated and followed for 1 year. Mean age of the patients was 75 years (range, 55-90 years). These patients were all classified as having occult choroidal neovascularization (CNV) with FA and polypoidal CNV with ICG angiography. Improvement of vision (>or=3 lines) was achieved in 15 eyes (50%). Nine eyes had stable vision (30%), and 6 eyes (20%) had a decrease in vision (>or=3 lines). Repeated treatment was required in 15 eyes (50%) for an average of 2.2 treatments in 1 year. CONCLUSION: This study indicates that stabilization or improvement of vision is achieved in most eyes (80%) with neovascular AMD from PCV after selected ICG angiography-guided PDT. These outcomes compare very favorably with those in previous reports on the treatment of occult CNV. Reduced collateral damage to the choriocapillaris and reduced upregulation of vascular endothelial growth factor are presumed to be the explanation for this apparently better outcome. Further studies with longer follow-up are warranted to investigate the long-term efficacy in these conditions.     

Radiotherapy for age-related macular degeneration: risk factors of complications, prevention and treatment of side-effects

PURPOSE: To analyze the retinal and choroidal side-effects of radiotherapy given for age-related macular degeneration (ARMD) and to describe the risk factors of these complications and their treatment. MATERIAL: and methods: Two hundred and ninety five eyes in 270 patients with ARMD were treated using radiotherapy. Nineteen patients had diabetes. The doses were as follows: 15 Gy or less (4 eyes); 16 Gy/4 fractions (113 eyes); 18 Gy/5 fractions (35 eyes); 20 Gy/5 fractions (123 eyes); 24 Gy/6 fractions (2 eyes); 28.8 Gy/8 fractions (17 eyes); more than 28.8 Gy (1 eye). Patients had a regular follow-up visit with visual acuity, contrast sensitivity evaluation, biomicroscopic fundus examination, fluorescein and ICG angiographies every six months over a mean period of 15 months. RESULTS: Radiation retinopathy was noted in 15 eyes, a bilateral neovascular glaucoma in one patient, ischemic optic neuropathy in 5 eyes, choroidal telangiectasiae in 19 eyes, venous occlusion in 2 eyes, oedematous retinopathy with major exudation (ORME) in 31 eyes, and choroidal hematoma in 8 eyes. Radiation retinopathy, choroidal telangiectasiae and ORME were related to radiation dose. Radiation retinopathy was more severe and more frequent in patients with diabetes. Choroidal telangiectasiae were diagnosed with ICG angiography and were treated early with laser. CONCLUSION: Radiotherapy for ARMD should not be done in patients with diabetes. Hypofractionation is not recommended. ICG angiography should be considered essential in the follow-up of patients treated with radiotherapy.     

Dye leakage in indocyanine green fundus angiography of a laser photocoagulated lesion]

Argon green laser photocoagulation was performed on adult pigmented rabbit eyes at various intensities (parameters:500 microns spot size, 0.2 sec. exposure, and 70-, 100-, 150- and 200-mW power levels), and fluorescein and indocyanine green (ICG) angiography was performed within one hour after coagulation. Each coagulum of ICG angiography was hypofluorescent in the early phase and brightly fluorescent in the late phase. The fluorescein and ICG dyes spread from the periphery to the center in the moderate and large coagula. The characteristic finding of ICG angiography was expansion of ICG dye around the coagulum, regardless of the degree of the coagulation. This ICG leakage was intra-choroidal because there was no fluorescein dye leakage around the coagulum. We concluded that the ICG dye leakage shows damage to the choroidal vessels due to laser photocoagulation, and is not related to the barrier function of the retinal pigment epithelium.     

Polypoidal choroidal vasculopathy with choroidal vascular hyperpermeability

PURPOSE: To describe the incidence and clinical characteristics of polypoidal choroidal vasculopathy (PCV) associated with choroidal vascular hyperpermeability. DESIGN: Retrospective observational case series. METHODS: We reviewed the medical records of 122 consecutive eyes with PCV and 106 consecutive eyes with exudative age-related macular degeneration (AMD). Fluorescein angiography and indocyanine green (ICG) angiography were performed using a confocal scanning laser system. In the midphase of ICG angiography, we evaluated choroidal vascular hyperpermeability, which is recognized as one of the characteristic findings in central serous chorioretinopathy (CSC). Choroidal vascular hyperpermeability appeared as multifocal patchy areas of hyperfluorescence with blurred margins within the choroid that increased in intensity with time after injection of the dye. RESULTS: Of 122 eyes with PCV, 12 (9.8%) eyes of 10 patients exhibited multifocal choroidal hyperfluorescence in the midphase of ICG angiography, whereas two (1.9%) of 106 eyes with exudative AMD showed a similar appearance (P = .013). Of the 12 eyes in 10 patients with PCV that demonstrated multifocal choroidal hyperfluorescence, we also noted that the early phase of ICG angiography showed choroidal filling delay in seven eyes (58%) and venous dilation in 12 eyes (100%). Four of these 12 eyes (33%) had a medical history of CSC, and nine (90%) of the 10 patients revealed multifocal choroidal hyperfluorescence bilaterally. CONCLUSIONS: Multifocal choroidal hyperfluorescence seen by ICG angiography occurs more frequently in eyes with PCV than in those with AMD. Choroidal vascular hyperpermeability, reportedly a characteristic finding in CSC, might be one of the risk factors of PCV.