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Purpose: To compare optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) findings in polypoidal choroidal vasculopathy (PCV) according to polyp type, polyp size and pigment epithelial detachment (PED) size., Method: Seventeen patients with PCV were included this study. The participants were divided into two groups according to ICGA images. Participants who had type I PCV formed group 1, and group 2 was comprised of patients with type II PCV. OCTA was performed for all participants. Polyp detection rates with OCTA and factors affecting this detection were assessed., Results: The mean age of all patients was 68.85±4.77 years (group 1 70.4±2.54 years, group 2 67.45±5.93 years). The rate of polyps seen in OCTA images was statistically significantly correlated with polyp type, polyp size, and PED size (r=0.633, p=0.002; r=0.64, P=0.001 and r=0.59, p<0.001, respectively). In group 1, the mean polyp size was 230.8±82.94μm, and the mean PED size was 161.3±73.87μm. In group 1, 10 patients with PCV were detected with ICGA, while only 1 (10%) PCV was detected with OCTA. In group 2, the mean polyp size was 387.90±245.90μm, and the mean PED size was 345.18±276.26μm. In group 2, 11 patients with PCV were detected with ICGA, while 8 (72.7%) of these patients were detected using OCTA., Conclusions: OCTA showed a greater percentage of detection of type II PCV than type I PCV. Polyp and PED size are important for the detection of PCV using OCTA., (Copyright © 2019. Published by Elsevier Masson SAS.)

Purpose: To update the medical literature on the diagnostic and therapeutic approach to polypoidal choroidal vasculopathy (PCV) and to propose a treatment algorithm in agreement with French market approval, supported by the France Macula Federation (FFM)., Methods: Literature review and expert opinion., Results: The diagnosis of PCV is based on multimodal imaging, including indocyanine green angiography (ICGA), which is considered the gold standard for the diagnosis of PCV. Regarding the therapeutic management of PCV, the FFM recommends treating PCV first-line either by monotherapy with intra-vitreal anti-vascular endothelial growth factor (anti-VEGF) injections, or by a combined treatment of photodynamic therapy (PDT) with Verteporfin and intra-vitreal anti-VEGF injections, depending on the location of the PCV., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Purpose: To evaluate baseline predictive markers of early and late anatomical response to anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with neovascular age-related macular degeneration (nAMD)., Methods: The records of the nAMD patients who underwent intravitreal ranibizumab or aflibercept treatment, received the 3 monthly loading doses, and completed a follow-up period of 12 months were included retrospectively. The anatomical treatment response at month 3 (early) and between month 3 and 12 (late) was classified as good, intermediate or poor. Baseline demographic, fluorescein angiography, and optical coherence tomography findings were compared among the three groups., Results: One hundred and ten eyes (74.3%) showed good, 18 (12.2%) showed intermediate and 20 (13.5%) showed poor anatomical response at month 3, and 114 eyes (77.0%) showed good, 27 (18.2%) showed intermediate and 7 (4.7%) showed poor anatomical response between month 3 and month 12. Of the evaluated parameters, drug type (better in aflibercept), showed a statistically significant difference in regards to anatomical outcomes at both the early and late periods (P=0.02 and P=0.03). The greatest linear dimension of choroidal neovascularization (CNV) and presence of peaked pigment epithelial detachment (PED) were important factors for early anatomical anti-VEGF treatment response., Conclusion: Larger CNV and the presence of a peaked PED appeared to be associated with a good early response, and the drug type seemed to be associated with both early and late poor anatomical response of anti-VEGF treatment in nAMD patients. Aflibercept appears to be more effective than ranibizumab in regards to the percentage of patients with better anatomical response in both the early and late treatment periods., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Purpose: To compare the changes in subfoveal choroidal thickness after intravitreal ranibizumab or aflibercept injections for neovascular age-related macular degeneration (nAMD)., Methods: In this retrospective study, 28 eyes with nAMD treated with 3 consecutive monthly injections of ranibizumab (IVR) and 24 eyes with nAMD treated with 3 consecutive monthly injections of aflibercept (IVA) between September 2012 and June 2016 were reviewed. The follow-up time was 6 months. Changes in two groups' best-corrected visual acuity (BCVA) and subfoveal choroidal thickness by using enhanced depth imaging optical coherence tomography at 1st, 3rd and 6th months were recorded and compared., Results: Choroidal thickness decreased significantly in eyes treated with IVR (P=0.015, 0.01 and 0.01, respectively) or IVA (P=0.001, 0.001 and ˂0.001, respectively) at 1, 3 and 6 months examination but IVA treated eyes presented a significantly further reduction in choroidal thickness when compared with ranibizumab (P=0.03, 0,04 and 0.03, respectively). There was no significant difference between aflibercept and ranibizumab group when change in BCVA from baseline compared at 1, 3 and 6th months (P=0.54, 0.06 and 0.37, respectively). There was no correlation between change in choroidal thickness and the BCVA outcomes in either group., Conclusions: Subfoveal choroidal thickness decreased significantly after both of IVR and IVA injections in patients with nAMD. In conclusion, intravitreal injections of ranibizumab or aflibercept affect not only neovascular lesion but also the underlying choroid., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Purpose: To evaluate the efficacy of intravitreal bevacizumab in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks., Methods: We conducted a prospective study in the ophthalmology department of Hassan II university hospital in Fez, including 12 eyes of 7 patients with CNV associated with angioid streaks. We injected 8 eyes with bevacizumab 1.25mg; best corrected visual acuity (BCVA), fundus examination, fluorescein angiography and optical coherence tomography were performed and analyzed for all patients before and after treatment. The goal of the study was to determine the percentage of patients with stabilization or improvement in BCVA and decreased central macular thickness., Results: Visual acuity on admission was <1/10 in 75% of patients. We injected 8 eyes with anti-VEGF, whereas abstention was appropriate for 4 eyes with disciform scarring. The average number of bevacizumab injections was 4.3±1.3 over a mean follow-up of 14.57 months±5.3. After treatment, BCVA was <1/10 in 12.5% of cases, between 1/10 and 5/10 in 50% of cases, and in 37.5% of patients, it was ≥5/10. Mean central macular thickness decreased from 424.25±137.03μm on admission to 255.75 microns±50.14 post-treatment (P=0.005)., Conclusion: Intravitreal bevacizumab is a promising and effective treatment option for the management of CNV associated with angioid streaks, with the requirement however of early treatment and extended follow-up., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Purpose: To describe the prevalence of macular complications in patients with visual acuity decrease related to high myopia (HM). To establish correlations between these complications and demographic or anatomical characteristics., Materials and Methods: Cross-sectional observational study including HM patients undergoing best-corrected visual acuity (BCVA), fundus examination, macular SD-OCT, and fluorescein angiography in the case of suspicion of choroidal neovascularization (CNV). The presence of anatomical criteria (staphyloma, subfoveal choroidal thickness [CT]) and macular complications (CNV, lacquer cracks, central chorioretinal atrophy, dome-shaped macula with serous retinal detachment [SRD], retinal foveoschisis, macular hole and epiretinal membrane) was investigated., Results: A total of 87 eyes of 47 patients were included (39 eyes without macular complication and 48 eyes with macular complications). In the case of macular complications, decrease in BCVA was related to CNV in 33%, macular hole in 25%, chorioretinal atrophy in 19%, foveoschisis in 11%, lacquer crack in 6%, to a dome-shape macula with serous retinal detachment in 4% and epiretinal membrane in 2%. After adjusting for interocular correlation and degree of myopia, staphyloma (P=0.0023), choroidal thinning (P=0.0036), and extrafoveal chorioretinal atrophy (P=0.042) were significantly associated with macular complications., Conclusions: High myopic patients with staphyloma or choroidal thinning should undergo regular comprehensive retinal screening for retinal complications., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Macular edema may complicate anterior, intermediate, and posterior uveitis, which may be due to various infectious, tumoral, or autoimmune etiologies. Breakdown of the internal or external blood-retinal barrier is involved in the pathogenesis of inflammatory macular edema. Optical coherence tomography has become standard in confirming the diagnosis of macular thickening, due to its non-invasive, reproducible and sensitivity characteristics. Fluorescein and indocyanine green angiography allows for, in addition to study of the macula, screening for associated vasculitis, detection of ischemic areas, easy diagnosis of preretinal, prepaillary or choroidal neovascular complications, and it can provide etiological information and may be required to evaluate the therapeutic response. Treatment of inflammatory macular edema requires specific treatment in cases of infectious or tumoral etiologies. If it remains persistent, or occurs in other etiologies, anti-inflammatory treatments are needed. Steroid treatment, available in intravitreal, subconjunctival and sub-Tenon's routes, are widely used. Limitations of local use include induced cataract and glaucoma, and their short-lasting action. Such products may reveal retinal infection. Thus, bilateral chronic sight-threatening posterior uveitis often requires systemic treatment, and steroids represent the classic first-line therapy. In order to reduce the daily steroid dose, immunosuppressant or immunomodulatory drugs may be added. Certain of these compounds are now available intravitreally., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Purpose: Extensive macular atrophy with pseudodrusen-like appearance (EMAP) is a recently described entity. We describe the first observations of choroidal neovascularization (CNV) associated with EMAP in 3 patients., Methods: Nineteen consecutive patients with EMAP were retrospectively investigated for the presence of CNV and treatment outcomes. Each patient underwent a complete ophthalmologic examination including color fundus photograpy, fluorescein angiography (FA), indocyanine green angiography (ICG) and spectral-domain optical coherence tomography (SD-OCT)., Results: Retrospective analysis revealed choroidal neovascularization in 3 patients (4 eyes) out of 19 patients with EMAP. In these patients, laser photocoagulation or intravitreal injections of ranibizumab led to resolution of retinal exudation with limited functional improvement., Conclusion: CNV is a possible complication of EMAP, a recently reported form of macular atrophy resembling geographic atrophy. Laser photocoagulation and anti-VEGF treatment appear to be two valuable therapeutic options., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Purpose: To evaluate the safety and efficacy of intravitreal bevacizumab (IVB) in the treatment of high myopic choroidal neovascularization (CNV)., Materials and Methods: Retrospective study of 16 eyes of 16 patients with high myopic choroidal neovascularization treated with first-line IVB (1.25mg/0.05mL) with a one-year follow-up. All patients underwent a complete baseline (M0) ophthalmologic examination, including the measurement of best corrected visual acuity (BCVA), biomicroscopic and fundus examination, fluorescein and indocyanine green angiography, and optical coherence tomography. Patients were followed monthly. Additional IVB was administered when persistent or additional retinal exudation was observed. The main study parameters were visual acuity at 1, 6 and 12 months and the progression of exudation on OCT and angiography., Results: Mean age was 63±14 years and spherical equivalent was -15.4±7.4 diopters. Baseline BCVA was 0.75±0.5 logMAR. Mean follow-up was 15±2 months. The average number of IVB was 2.4±1.2 injections. Metamorphopsia decreased in all patients and completely disappeared in fourteen eyes. Mean BCVA was 0.5±0.3 logMAR at M1 and 0.6±0.5 logMAR at M6 and M12. No adverse events related to the intravitreal injections were observed., Conclusion: Our study showed that IVB (Avastin(®)) is effective in the treatment of high myopic CNV. Moreover, only a small number of intravitreal injections were required to treat this condition., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Purpose: Prospective evaluation of aqueous flare following intravitreal bevacizumab (Avastin, Genentech Inc., San Francisco, CA, USA) injections in eyes with choroidal neovascularization due to age-related macular degeneration., Patients and Methods: Sixteen eyes of eight patients were recruited. Aqueous humor flare was determined by laser flare meter every month after one intravitreal injection of 1.25mg of bevacizumab at baseline followed by a second injection at month3 (day 100±21days). Four patients received an injection at month6 (±10days), and one patient received an injection at month7., Results: Two months after the first intravitreal bevacizumab injection, flare values decreased from 10±5.57 (mean±standard deviation) to 5.2±1.69photon count/ms (P=0.0207) and from 8.3±3.59 to 5.4±0photon counts/ms, 2months after the second injection (P=0.02)., Conclusion: Significantly decreased aqueous humor flare levels were noted after repeated injections of bevacizumab., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Purpose: To measure macular choroidal thickness (CT) using spectral-domain optical coherence tomography (SD-OCT) in eyes with myopic macular choroidal neovascularization (CNV), and to compare choroidal thickness in these eyes with highly myopic eyes without CNV., Patients and Methods: Sixty-four eyes with myopic CNV matched with 64 highly myopic eyes without CNV by age and axial length (AL) were examined between January 2010 and November 2011. OCT scans were performed with spectral-domain OCT (TOPCON OCT 2000). The reference position was changed from the vitreous to the choroid. OCT scan patterns consisted of seven sections; the subfoveal CT was measured manually between Bruch's membrane and the internal portion of the sclera in eyes with CNV and from the pigment epithelium to the scleral interface in eyes without CNV., Results: In the subgroup with CNV, the mean subfoveal CT was 51.71 μm ± 17.35. A statistically significant negative correlation was found between CT and AL (r=-0.615, P=0.0001). Regression analysis demonstrated a decrease of 8.4 μm per mm of AL. In the subgroup without CNV, matched with the CNV subgroup by age (P=0.597), and AL (P=0.813), the mean subfoveal CT was 93.35 μm ± 34.81 μm. The difference between the two subgroups was statistically significant (P<10(-4))., Discussion: Macular choroidal thickness is reduced in high myopia, especially when complicated by CNV. It has not yet been shown that choroidal thinning may be a risk factor for choroidal neovascularization, but our results may suggest that macular choroidal thinning may lead to hypoxic retinal changes resulting in secretion of VEGF and thus CNV., Conclusion: Macular choroidal thinning observed in high myopia with CNV. These findings may suggest that choroidal changes may play a role in the pathogenesis of choroidal neovascularization., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Purpose: The purpose of this study was to evaluate the efficacy and safety of bevacizumab in the first-line treatment of myopic choroidal neovascularization., Patients: We report a retrospective study of patients with subfoveal or juxtafoveal choroidal neovascularization associated with pathologic myopia treated with intravitreal injection of bevacizumab in Lyon, France, from January 2009 to June 2010. Best-corrected visual acuity, ocular pressure, fundus examination, optical coherence tomography, and fluorescein angiography were performed for each patient at baseline and monthly. Indications for retreatment were persistent or recurrence of exsudative activity., Results: The study included eight eyes of eight patients. The mean follow-up time was 19 months. The mean number of intravitreal injections was three at the end of the first year. Six patients maintained or improved their vision. No injection complications or drug-related side effects were noted during the follow-up period., Conclusions: In this study, intravitreal injection of bevacizumab seems to be a safe and effective treatment for myopic choroidal neovascularization., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Purpose: To compare the long-term safety and of intravitreal bevacizumab injections (IVB) and verteporferin photodynamic therapy (PDT) in the treatment of choroidal neovascularization (CNV) in high myopia., Methods: Review of retrospectively collected data of 60 eyes of 60 patients with high myopic choroidal neovascularization treated either with standard PDT (PDT group; n=30) or IVB injections (IVB group; n=30). The two groups were compared at baseline, 3, 6,12 and 24 months., Results: In the IVB group, mean best corrected visual acuity (BCVA) was significantly improved at 3 to 12 months; however, the significance was lost at 24 months. The PDT group showed an insignificant improvement at 3 and 6 months, then worsened at 12 and 24 months. Mean BCVA was better in the IVB group than the PDT group at 3, 6, 12 and 24 months. The decrease in mean central macular thickness was significantly higher in the IVB group than in the PDT group at 3, 6, 12 and 24 months. At 24 months, chorioretinal atrophy was noted in five eyes (16.6%) treated with IVB and in 22 eyes (73.3%) treated with PDT (P=2×10(-5))., Conclusion: IVB provides significantly better BCVA than PDT for high myopic CNV over the long-term., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Angioid streaks represent linear breaks in Bruch's membrane secondary to a change in the elastic layer. They are often associated with pseudoxanthoma elasticum. We report the case of a 36-year-old man with no prior history who was seen for a macular problem in the left eye, eventually involving the right eye after 3 months. He was diagnosed with pseudoxanthoma elasticum, associated with angioid streaks, complicated by choroidal neovascularization in both eyes. He was treated with intravitreal ranibizumab injections (0.5 mg/0.05 mL). His course in the right eye was remarkable for stable improvement at 3 months after the final injection. In the left eye, after initial improvement, recurrence was noted 2.5 months after injection, with subfoveal progression of the choroidal neovascularisation, unresponsive to a fourth ranibizumab injection. Angioid streaks represent a degenerative retinal pathology of elastic tissue with the potential for ingrowth of choroidal neovascularization. Various therapeutic approaches such as photodynamic therapy or laser photocoagulation have been proposed, with variable and sometimes limited results. Intravitreal ranibizumab injections currently remain the best treatment and should be studied with a longer-term, larger series., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Angioid streaks represent breaks in Bruch's membrane, appearing as dark or reddish radial streaks eminating from the optic disc. Usually asymptomatic, these streaks may develop neovascularisation and lead to a maculopathy with marked loss of vision. Some associations with systemic disease are classically described, especially pseudoxanthoma elasticum. This condition may involve cardiovascular complications. A mutation has been found in the ABCC6 gene, which encodes for a membrane transport protein involved in the synthesis of the extracellular matrix. Imaging allows for visualization of the extent of the streaks, and autofluorescence is particularly informative. Spectral domain OCT may also demonstrate early breaks in Bruch's membrane. Neovascular complications, previously responsible for inevitable visual impairment at some point after their occurrence, are now managed by intravitreal injections of anti-VEGFs with clear efficacity. The ophthalmologist must be aware of this condition, in order to guide the patient towards a systemic work-up if necessary, and also to insure quick and targeted treatment in the case of neovascular complications., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Introduction: Myopic choroidal neovascularization (CNV) is the first cause of CNV in young patients. The aim of this study was to compare the efficacy of intravitreal injections (IVT) of ranibizumab with photodynamic therapy (PDT) in this indication., Patients and Methods: Retrospective comparative study analyzing the visual acuity (VA) outcomes of CNV myopic patients treated with either IVT or PDT., Results: Twenty-seven eyes of 25 patients were treated with PDT (group 1) and 18 eyes of 17 patients were treated with IVT of ranibizumab (group 2). Demographic data were similar in the two groups. The median initial VA was 20/80 for group 1 and 20/160 for group 2 (P=0.37). At 1 year, the median VA was 20/80 for group 1 (P=0.32) and 20/63 for group 2 (P=0.04). A significant improvement in VA was observed in 23.1% and in 27.3% of cases in groups 1 and 2, respectively (P=0.53). A significant VA worsening was observed in 34.6% of cases in group 1 and in 9.1% of cases in group 2 (P=0.21)., Conclusion: IVT of ranibizumab compared to PDT treatment showed greater efficacy in this study., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Purpose: To report the angiographic and optical coherence tomography (OCT) features of isolated "perifoveal exudative vascular anomalous complex (PEVAC)", a peculiar clinical entity., Methods: A complete ophthalmologic examination was performed in two patients (a 82-year old woman [case 1]; a 52-year old man [case 2]) that were referred to our department for unilateral blurred vision., Results: In both cases, fundus examination of the right eye showed a perifoveal isolated large aneurismal change, accompanied by small hemorrhages, intraretinal exudation, and small hard exudates accumulation. Both FA and ICGA revealed the absence of any other retinal or choroidal vascular abnormality associated. OCT showed a round hyperreflective lesion in correspondence of the perifoveal vascular anomalous complex, surrounded by intraretinal cystic spaces. In case 2, the lesion remained unchanged despite 3 monthly intravitreal injections of ranibizumab., Conclusion: PEVAC may develop in absence of capillary ischemia or inflammation, probably due to progressive retinal endothelial cell degeneration. This could explain the unresponsiveness to anti-VEGF treatments., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Unlabelled: We report a case of a high myopic patient, treated with photodynamic therapy for macular neovascularization in the presence of silicon oil. Four months later, the patient's vision was again at 4/40, with no active neovascularization., Introduction: Retinal detachment and macular neovascularization are common complications in high myopia patients. Sometimes these two conditions occur simultaneously and their treatment can become more problematic., Observation: We report the case of a high myopia patient treated with photodynamic therapy for subfoveal neovascularization through a vitreous cavity filled with silicone oil. The treatment was successfully completed with no problems., Conclusion: Photodynamic therapy can be achieved successfully through a vitreous cavity filled with silicone oil., (Copyright © 2011. Published by Elsevier Masson SAS.)

Purpose: To investigate the effect of a triple therapy associating subtenon triamcinolone acetonide, intravitreous ranibizumab and photodynamic therapy for treatment of retinal pigment epithelium detachment (RPED) complicating occult choroidal neovascularization in age-related macular degeneration. PATIENTS-METHOD: A prospective clinical trial including 27 patients showing retinal pigment epithelium detachment. We treated these patients with intravitreous ranibizumab injections and subtenon triamcinolone injections as well as a single session of photodynamic therapy at 48 h. At least two more intravitreous ranibizumab injections were added at 1-month intervals., Results: Initial visual acuity was 1.3/10 at 9 months, which was minimal follow-up. Twenty-three patients had total resumption of retinal pigment epithelium detachment on optical coherence tomography imaging after 1 month. One patient had ocular hypertension and needed trabeculectomy, one had a pigment epithelium break but with good functional results. Seven patients needed six intravitreous injections of ranibizumab with partial or total resumption in six cases., Discussion: RPED is a severe complication of choroidal neovascularization in age-related macular degeneration. Untreated, it means a rapid loss of macular function. Often damage is bilateral. Simple intravitreous injection of ranibizumab is not satisfying. An association of photodynamic therapy and intravitreous triamcinolone injections shows good results. We propose a triple treatment for the best possible synergy. Our preliminary results are encouraging. Since we did not want to inject a large volume of Triamcinolone into the vitreous, we chose subtenon injections., Conclusion: Treatment of retinal pigment epithelium detachment is difficult. Associating intravitreous injection of ranibizumab, dynamic phototherapy, and subtenon triamcinolone provides good results., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Introduction: The hemorrhagic complications of the optic disk drusen are rare and interesting because of their functional implications, the difficulty of the differential diagnosis and the uncertain pathogeny., Material: and methods: Retrospective study of 6 cases with a complete general and ophthalmological examination, followed between 2 and 9 years., Results: The average age of the cases was 38.5 years (9-62 years). The visual acuity was slightly affected and reversible in the papillary hemorrhages (1 case), low and partial reversible in the extended hemorrhages (4 cases), severe affected and irreversible in the associations with a choroidal neovascular membrane with macular implications (1 case). We found three types of hemorrhages: papillary (1 case), peripapillary associated with choroidal neovascular membrane in acute (2 cases) and cicatricial stage (1 case), extended subretinal (2 cases). The papillary drusen were profound (4 cases) and superficial (2 cases). Ultrasonography showed the presence of the optic disk drusen in both eyes in all cases. The evolution followed on a period from 2 to 9 years, revealed the resorbtion of the hemorrhages between 3 and 6 months, the reversible visual acuity in the cases without macular implication, and the absence of recidiva or bilateralisation., Discussions and Conclusions: The authors are presenting a number of clinical cases of papillary drusen complicated with hemorrhages, some of the cases being associated with choroidial neovascular membrane. Because of the clinical appearance, aspects of differential diagnosis with papillary edema of other etiologies are discussed. A role in the pathogeny is attributed to the direct or progressive compression of the retinal vascularisation which can provoke the erosion of the vessels and in some cases the appearance of the choroidal neovascular membrane. The suggested therapy is medical, surgical, or by photocoagulation, but the results are contradictory.

Introduction: Controlled clinical trial results of occult choroidal neovascularization (CNV) management in age-related macular degeneration (AMD) using intravitreal injections of Ranibizumab have shown significant improvement in vision for the treated group., Case Report: The first clinical case of minimally classic CNV is reported here with the results at 6 months, not only with changes in visual acuity but also with complete imaging at each follow-up with fluorescein angiography, infracyanine angiography using the scanning laser ophthalmoscope (SLO) and with OCT examination. After the second injection, the patient experienced improvement in vision and complete regression of all symptoms to date (5 months after the first injection), showing very favorable progression during the entire follow-up., Conclusion: This clinical case shows extremely favorable progression of the minimally classic lesion resulting from the first two injections of Lucentis. The situation is now stabilized in terms of function and morphology, as shown by the fluorescein and infracyanine SLO angiography and OCT examination.

Objective: Fundus flavimaculatus is an aspect of Stargardt disease, which is characterized by juvenile onset, rapidly progressive deterioration, and poor visual outcome due to atrophic areas or flecks. Recently, a late-onset form has been described, on the borderline with AMD. However, choroidal neovascular complications are not frequent and rarely described in Stargardt's disease., Case Report: Late discovery of FFM in a patient over 50 years old. During her follow-up, she presented a decrease in visual acuity due to juxtafoveal choroidal neovascularization. In spite of laser treatment, a retrofoveal recurrence appeared, which was treated with perifoveal laser., Discussion: Confusion between AMD and a late-onset Stargardt may occur because of their many clinical similarities. The population and the fundus results can be similar to AMD and an examiner may be confused. In the literature, choroidal neovascular complications appear in patients over 50 years of age who may suffer from AMD. In fundus flavimaculatus, pigmentary epithelium alterations are due to progressive lipoproteic scrap storage that predisposes to Bruch's membrane rupture and choroidal neovascularization. This physiopathology resembles the that of AMD., Conclusion: Choroidal neovascular complications are possible in late-onset Stargardt disease. Their appearance together may be greater than previously believed.

Purpose: In the mid-late life, basal laminar drusen can be associated with vitelliform macular degeneration and choroidal neovascularization. The differential diagnosis between these two clinical entities is not always easy with fluorescein angiography. The aim of this case report is to describe the indocyanine green angiographic features of basal laminar drusen and pseudo-vitelliform material and to evaluate the role of ICG angiography in differentiating new choroidal vessels from vitelliform macular degeneration., Patients and Methods: Six patients (12 eyes) with central visual loss and metamorphopsia underwent a biomicroscopic examination. Diagnosis was basal laminar drusen and bilateral vitelliform macular degeneration. Fluorescein and indocyanine green angiographies were performed and the results were compared., Results: In all eyes, basal laminar drusen were hyperfluorescent with both angiographies. On fluorescein angiography, the macular material was hypofluorescent early, but gradual staining occurred from the borders in the late phase. In 8 out of the 12 eyes, fluorescein angiographic characteristics of the macular lesions could not provide clues to differential diagnostic between new choroidal vessels and vitelliform material. On indocyanine green angiography, in 8 eyes the material remained intensely hypofluorescent during the whole sequence. In 4 eyes, indocyanine green angiography allowed the identification of hyperfluorescent well-defined new choroidal vessels., Conclusions: Indocyanine green angiography allows the visualization of basal laminar drusen and can easily differentiate choroidal neovascularization from acquired vitelliform degeneration.