Age-related scattered hypofluorescent spots on late-phase indocyanine green angiography: the multimodal imaging and relevant factors

Abstract

Importance: Fundus aging and its imaging features. Background: To characterize the demographic and multimodal-imaging features of age-related scattered hypofluorescent spots on late-phase indocyanine green angiography (ASHS-LIA). Design: A hospital-based retrospective study. Participants: Eight hundred and seventy-five normal fundi fellow eyes from 875 patients underwent indocyanine green angiography (ICGA), fluorescence angiography (FA), autofluorescence (AF) and spectral-domain optical coherence tomography (OCT). Methods: Demographic information, medical records and multimodal imaging data were reviewed. Main Outcome Measures: Diameter of ASHS-LIA and its grade, subfoveal choroidal thickness (SFCT). Results: ASHS-LIA was identified in 233 patients (26.6%) aged 33 to 87 years (mean: 65.8 ± 8.4 years). Patients with ASHS-LIA were significantly older and had a higher male proportion than those without ASHS-LIA (both P < 0.001). The occurrence and grade of ASHS-LIA increased with age (all P < 0.001). Age (OR = 1.093) and male gender (OR = 1.550) were the independent relevant factors of ASHS-LIA (P < 0.001, and P = 0.002, respectively). The incidence of ASHS-LIA in polypoidal choroidal vasculopathy (PCV) patients (53.2%) was the highest (all P < 0.001). ASHS-LIA mainly located in macular region (diameter: 100–500 μm), and could be confluent. No corresponding abnormalities were detected via multimodal imaging, including FA, AF and OCT. The mean SFCT had no significant difference between eyes with and without ASHS-LIA (P = 0.221). Conclusions and Relevance: ASHS-LIA was observed on late-phase ICGA, mainly located in macular region. No corresponding abnormalities were detected by other multimodal imaging, including FA, AF and OCT. The occurrence and grade of ASHS-LIA increased with age. Moreover, ASHS-LIA might be not correlated with SFCT, but correlated with PCV.