Purpose The authors report the cases of two patients affected with idiopathic choroidal neovascularisation studied with combined fluorescein angiography and indocyanine green (lCG) angiography. In particular the presence of choroidal abnormalities at ICG angiography which could not be detected by fluorescein angiography was studied.Methods Both patients underwent a complete systemic and ocular assessment. A subretinal neovascular membrane, located in the macular zone, is not frequent in patients under 50 years of age. There exists a distinct subset of young patients in whom choroidal neovascularisation (CNV) develops in the absence of any detectable primary ophthalmic or systemic disease which has been recognised to cause submacular neovascular membranes.1-3 When no apparent cause or association can be determined, the subretinal neovascular membrane in patients younger than 50 years of age is classified as idiopathic (ICNV).4-12Few cases of ICNV studied with combined fluorescein angiography and indocyanine green (ICG) angiography have been reportedy,14 We report the cases of two patients with macular subretinal neovascular membranes which were diagnosed as idiopathic at fluorescein angiography and in which ICG angiography demonstrated abnormalities of the choroidal vasculature.
Case reports
Case 1A healthy 30-year-old woman noted sudden, painless blurring of vision in her right eye. Medical, surgical and ocular history was unremarkable and she was taking no medications. There was no family history of eye disease.On examination 1 week after the onset of symptoms, visual acuity was 20/60 in the right eye and 20/20 in the left eye with a refractive error of 1.75 dioptres of myopia in both eyes. An Amsler grid test was altered in the right eye and normal in the left eye. There was no evidence of an afferent pupillary defect. Results of anterior segment examination were normal in both eyes. Results of dilated fundus examination of the right eye showed a grey submacular lesion surrounded by subretinal blood and an overlying neurosensory retinal detachment; the optic disc and retinal vessels were normal (Fig. la); the overlying vitreous was clear. The left fundus was normal, except for the presence of a pinpoint area of retinal pigment epithelium (RPE) atrophy in the macular region (Fig. Ib). At fluorescein angiography the lesion showed an early net-shaped hyperfluorescence which Eye (1999) 13, 621�28