Clinicopathologic correlation of fluorescein and indocyanine green videoangiography in occult choroidal neovascularization

Purpose: To correlate the histopalhologic features of a postmortem eye with fluorescein and indocyanine green (ICG) angiography performed to evaluate recurrent occult choroidal neovascularization (CNV). Methods: Histopathologic features from serial sections through the macula of a 76 year old man with recurrent occult CNV were reconstructed in a scaled two dimensional map and overlaid on fluorescein and ICG angiogram images obtained four months prior to his death Results: Choroidal fibrosis and absent choriocapillaris in the region of prior laser photocoagulation corresponded to a well demarcated hypofluorescent region in the early frames of the fluorescein angiogram and the early and late phases of the ICG angiogram A thin predominantly intra-Bruch's fibrovascular membrane corresponded to stippled late hyperfluorescence on the fluorescein angiogram and to mild late hyperfluorescence on the ICG angiogram Adjacent to the region of prior laser photocoagulation, thick intra-Bruch's and sub-retinal fibrovascular complexes contained a high density of vessels and basophilic extracellular matrix and corresponded to elevated late hyperfluorescence on the fluorescein angiogram and intense late hyperfluorescence on the ICG angiogram Conclusion: Histopathologic mapping revealed a larger than expected fibrovascular complex within Bruch's membrane which correlated well with findings on fluorescein and ICG angiography.