A 58-year-old patient presents with recurrent episodes of painless subretinal hemorrhage and serous retinal detachment in one eye. Fundus fluorescein angiography (FFA) shows branching vascular network and polypoidal lesions, but the extent of the lesion is unclear due to overlying hemorrhage. Which imaging modality is the most appropriate next step for definitive diagnosis?
- A Enhanced depth imaging OCT (EDI-OCT)
- B Indocyanine green angiography (ICGA) ✓
- C Fundus autofluorescence (FAF)
- D Standard B-scan ultrasonography
Correct answer: B. Indocyanine green angiography (ICGA)
Explanation
ICGA uses near-infrared fluorescence that penetrates through hemorrhage and pigment better than fluorescein, making it the gold standard for visualizing polypoidal choroidal vasculopathy (PCV) lesions. EDI-OCT can show polyps but may miss smaller lesions. FAF and B-scan do not delineate the vascular network definitively.
Reference: Ryan's Retina, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.