Background: Although choroidal neovascularization has a recognized role in the formation of retinal pigment epithelial tears in the setting of age-related macular degeneration, there frequently was no fluorescein angiographic evidence of choroidal neovascularization in published series.
Methods: Three consecutive patients with a folded retinal pigment epithelium in a subfoveal location, which was associated with a serous macular detachment in the setting of age-related macular degeneration, were studied with intravenous fluorescein angiography and indocyanine green angiography.
Results: Fluorescein angiography demonstrated no well-defined choroidal neovascular membrane, although there was evidence of occult choroidal neovascularization. The folded retinal pigment epithelium blocked fluorescence. Indocyanine green angiography demonstrated placoid subfoveal hyperfluorescence consistent with choroidal neovascularization in the region of the folded retinal pigment epithelium and fibrovascular pigment epithelial detachment. Hypofluorescence was noted within the region of the retinal pigment epithelial tear.
Conclusion: Indocyanine green angiography in our cases clearly demonstrated the presence of presumed choroidal neovascularization in the setting of retinal pigment epithelial tears secondary to age-related macular degeneration.