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Near-Infrared Subretinal Imaging in Choroidal Neovascularization

  • Chapter
Medical Retina

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

Core Messages

  • Current therapeutic strategies for treatment of choroidal neovascularization (CNV) require frequent monitoring of neovascular activity, which calls for a noninvasive, low-risk imaging technique.

  • Ocular coherence tomography (OCT) focuses on static anatomical features like retinal thickening and the presence of sub- and intraretinal fluid, whereas fluorescein angiography employs a longer time frame better suited to address the dynamic aspect of active fluid leakage.

  • Near-infrared imaging can be used in the general clinical setting using a commercially available confocal scanning laser device (Heidelberg Retina Angiograph 2).

  • Near-infrared reflectance (NIR) imaging provides information on alterations in the retinal structure, subretinal lesions, and the accumulation of fluid within and beneath the retina and the retinal pigment epithelium (RPE). Therefore, NIR complements aspects of both fluorescein angiography and OCT in a noninvasive way.

  • Increased intra- and subretinal fluid content reduces NIR and causes a characteristic dark halo around a lesion.

  • A classic CNV typically shows a dark core surrounded by a bright corona on NIR imaging.

  • The near-infrared image of occult neovascular membranes and detachments of the RPE are less distinctive when compared with classic neovascular membranes. An occult lesion shows an uneven signal increase; a RPE detachment typically presents with a poorly defined ring-shaped reflex.

  • Following successful therapeutic intervention, certain alterations occur in the near-infrared image of the choroidal neovascular membrane. Digital subtraction analysis may be employed to enhance these alterations to ­accurately assess treatment efficacy.

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Authors and Affiliations

  1. Department of Ophthalmology, Radboud University Nijmegen Medical Centre, Philips van Leydenlaan 15, Nijmegen, 6525 EX, The Netherlands

    Thomas Theelen, Carel B. Hoyng & B. Jeroen Klevering

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  1. Thomas Theelen
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  2. Carel B. Hoyng
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  3. B. Jeroen Klevering
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Correspondence to Thomas Theelen .

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Editors and Affiliations

  1. Department of Ophthalmology, University of Bonn, Ernst-Abbe-Straße 2, Bonn, 53127, Germany

    Frank G. Holz MD (Professor and Chairman) (Professor and Chairman)

  2. Private Practice Vitreous, Retina, and Macula Consultants of New York, 460 Park Avenue, New York, NY 10022, USA

    Richard Spaide MD

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Theelen, T., Hoyng, C.B., Klevering, B.J. (2010). Near-Infrared Subretinal Imaging in Choroidal Neovascularization. In: Holz, F.G., Spaide, R. (eds) Medical Retina. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85540-8_8

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  • DOI: https://doi.org/10.1007/978-3-540-85540-8_8

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