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  • Indocyanine green angiography in the algorithm of diagnostics of polypoidal chrioidal vasculopathy in age-related macular degeneration

    Редактор | 2017, Practical medicine 09 (17) Ophthalmology. Part 2 | 6 сентября, 2017

    T.B. SHAIMOV1, I.E. PANOVA2, V.A. SHAIMOVA3

    1South-Ural State Medical University, 64 Vorovskogo Str., Chelyabinsk, Russian Federation, 454092

    2Saint-Petersburg branch of S. Fyodorov Eye Microsurgery Federal State Institution, 21 Yaroslav Gashek Str., Saint-Petersburg, Russian Federation, 192283

    3Multidisciplinary Center for Laser Medicine, 287 Prospekt Pobedy, Chelyabinsk, Russian Federation, 454021

     Shaimov T.B. — post-graduate graduate student of the Department of Eye Diseases, e-mail: timur–shaimov@mail.ru

    Panova I.E. — D. Med. Sc., Professor, Deputy Director for Research, tel. (812) 324-66-66, e-mail: eyeren@yandex.ru

    Shaimova V.A. — D. Med. Sc., Leading Researcher, tel. (351) 741-23-68, e-mail: shaimova.v@mail.ru

    16 patients (16 eyes) with neovascular age-related macular degeneration were examined. In all patients polypoidal choroidal vasculopathy was diagnosed with the help of indocyanine-green angiography. Besides a standard ophthalmologic research, the spectral-domain optical coherence tomography (OCT) and OCT-angiography was performed to all patients. In patients with PCV the most common ophthalmoscopic sign was hard exudate (93.8%), red-orange subretinal nodules (81.3%), hemorrhages were detected in 5 eyes (31.3%). In most eyes, the absence of macular druses (75%) was detected. In all patients with polypoid choroidal vasculopathy, a dome-shaped detachment of retinal pigment epithelium was detected. Intraretinal hyperreflective inclusions (hard exudate) and a double layer feature were detected in 15 eyes (93.8%). The tomographic notch sign was revealed in 13 eyes (81.3%), the bubble sign — in 14 eyes (87.5%). Subretinal fluid was detected in 8 eyes (50%). When carrying out indocyanine-angiography, the node section of hyperfluorescence was diagnosed in 14 of 16 patients (87.5%), which in most cases was represented by a single focus (71.4%). In the OCT-angiography, «polyps» were diagnosed in 12 of 16 patients (75.0%). The use of OCT-angiography allowed to reveal an abnormal vasculature under the pigment epithelium in all patients of this group (100%), mainly of a tree-like configuration (87.5%). During the ICG, nine patients showed signs of a branching vascular network (56.3%). The proposed diagnostic algorithm based on comparison (with indocyanine green) of ophthalmoscopic, OCT-morphometric and OCT angiographic features allows verifying this pathology, which is very important in determining the treatment strategy.

    Key words: age-related macular degeneration, polypoidal choroidal vasculopathy, optical coherence tomography angiography, indocyanine-green angiography, optical coherence tomography.

     

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    Метки: 2017, I.E. PANOVA, Practical medicine 09 (17) Ophthalmology. Part 2, T.B. SHAIMOV, V.A. SHAIMOVA

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