Indocyanine green angiography of well-defined plaque choroidal neovascularization in age-related macular degeneration

Objective: To determine the natural course of well-defined plaque choroidal neovascularization (CNV) using indocyanine green angiography. Methods: Two ophthalmologists, experts in macular diseases and indocyanine green angiography, examined 40 eyes with exudative age-related macular degeneration and a well-defined plaque CNV using complete ophthalmoscopic evaluation, fluorescein angiography, and indocyanine green angiography. The increase in the size of the plaques was analyzed using multivariate analysis, in relation to the worsening of visual acuity, with adjustment for age, sex, and length of follow-up. Results: Mean follow-up was 13.5 months (median, 11 months). Initial and final mean visual acuity were 20/46 (median, 20/50) and 20/65 (median, 20/100), respectively. The mean initial size of the plaque was 6.62 mm² (median, 6.20 mm²), and the mean final size was 10.40 mm² (median, 9.76 mm²). The enlargement was statistically significant (P <001). Conclusions: We found that plaque CNV tends to become larger with time, the enlargement reaching about 40% in 1 year of follow-up. The resulting loss of visual acuity, however, is not significant, and is slightly correlated with the extension of the lesion; it also does not appear to be directly related to sex.