Clinical significance of postlaser indocyanine green angiographic hot spots in age-related macular degeneration.

Abstract

To report the natural history and clinical significance of indocyanine green (ICG) angiographic hot spots in age-related macular degeneration (ARMD) after laser photocoagulation. Retrospective noncomparative case series. Two hundred thirty consecutive patients with exudative ARMD who underwent krypton laser treatment between March 1993 and December 1996. Krypton laser photocoagulation was performed on all patients. Digital videoangiograms, including both fluorescein angiography and ICG angiography, were obtained at 2 weeks, 4 weeks, 6 weeks, and 3 months postlaser treatment on each patient and repeated if clinical changes were noted. Detection by ICG of hyperfluorescent spots (hot spots) within the hypofluorescent laser-treated area. Forty patients (18%) developed ICG hot spots 2 weeks after laser treatment. The hot spots disappeared spontaneously without recurrent choroidal neovascular (CNV) membrane in 31 patients (78%). Recurrent CNV was discovered at the hot spot in four patients and away from the hot spot in five patients. The postlaser ICG angiographic hot spot is not rare. These spots tend to disappear spontaneously and do not necessarily represent a recurrent CNV. The presence of a hot spot on ICG angiography is not an indication for immediate laser retreatment.