Korean J Ophthalmol.  2012 Jun;26(3):230-234. 10.3341/kjo.2012.26.3.230.

Indocyanine Green Angiographic Findings of Obscure Choroidal Abnormalities in Neurofibromatosis

Affiliations
  • 1Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. nuntangi5@gmail.com

Abstract

We report two cases of choroidal neurofibromatosis, detected with the aid of indocyanine green angiography (ICGA) in patients with neurofibromatosis (NF)-1, otherwise having obscure findings based on ophthalmoscopy and fluoresceine angiography (FA). In case 1, the ophthalmoscopic exam showed diffuse bright or yellowish patched areas with irregular and blunt borders at the posterior pole. The FA showed multiple hyperfluorescent areas at the posterior pole in the early phase, which then showed more hyperfluorescence without leakage or extent in the late phase. The ICGA showed diffuse hypofluorescent areas in both the early and late phases, and the deep choroidal vessels were also visible. In case 2, the fundus showed no abnormal findings, and the FA showed weakly hypofluorescent areas with indefinite borders in both eyes. With the ICGA, these areas were more hypofluorescent and had clear borders. Choroidal involvement in NF-1 seems to occur more than expected. In selected cases, ICGA is a useful tool to be utilized when an ocular examination is conducted in a patient that has no definite findings based on the ophthalmoscope, B-scan, or FA tests.

Keyword

Choroid; Choroidal neurofibroma; Indocyanine green angiography; Neurofibromatoses

MeSH Terms

Child
Choroid/*pathology
Choroid Diseases/*diagnosis/etiology
Coloring Agents/diagnostic use
Diagnosis, Differential
Female
Fluorescein Angiography
Follow-Up Studies
Fundus Oculi
Humans
Indocyanine Green/*diagnostic use
Male
Middle Aged
Neurofibromatosis 1/*complications/diagnosis

Figure

  • Fig. 1 Case 1. Diffuse bright or yellowish patched areas with irregular and blunt borders at the posterior pole (A). Early-phase fluorescein angiography of the same eye shows several hyperfluorescent areas at the posterior pole, and these areas correspond to the bright patched areas that are seen in fundoscopy. These represent the zones of retinal pigmented epithelium alterations. These areas appear more hyperfluorescent with the same extent in the late phase (B,C). Indocyanine green angiography showed diffuse hypofluorescent areas in both the early and late phases, and the deep choroidal vessels are visible within the hypofluorescent area (D,E).

  • Fig. 2 Case 1. Diffuse bright or yellowish patched areas with irregular and blunt borders at the posterior pole (A). Early-phase fluorescein angiography of the same eye shows several hyperfluorescent areas at the posterior pole, and these areas correspond to the bright patched areas that are seen in fundoscopy. These represent the zones of retinal pigmented epithelium alterations. These areas appear more hyperfluorescent with the same extent in the late phase (B,C). Indocyanine green angiography showed diffuse hypofluorescent areas in both the early and late phases, and the deep choroidal vessels are visible within the hypofluorescent area (D,E).


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