A pilot study of digital indocyanine green videoangiography for recurrent occult choroidal neovascularization in age-related macular degeneration.
OBJECTIVE
Digital indocyanine green videoangiography (ICG-V) was used to study recurrent choroidal neovascularization (CNV) in patients with the clinical and fluorescein angiographic findings indicative of ill-defined, or recurrent occult, CNV (RO-CNV). The use of ICG-V-guided laser caphotocoagulation as an alternative form of treatment was also investigated when a well-delineated area of CNV was imaged with this technique.


METHODS
A consecutive series of 66 patients were studied who presented with exudative age-related macular degeneration and symptoms and clinical manifestations of recurrent CNV in which fluorescein angiography did not reveal classic, or well-defined, neovascularization. Patients were selected for laser treatment based on conventional guidelines if ICG-V imaged a well-delineated area of recurrent CNV.


RESULTS
Indocyanine green videoangiography showed late staining that was consistent with recurrent CNV in 64 (97%) of these 66 patients with RO-CNV. Twenty-nine (44%) of the 66 were eligible for laser treatment, and 18 (62%) of these 29 patients experienced successful anatomic and visual results, which were defined as resolution of the exudative manifestations and improvement or stabilization (+/- 1 line on a Snellen chart) of vision.


CONCLUSIONS
This pilot study suggests that ICG-V is of value in imaging patients with RO-CNV after laser photocoagulation for CNV secondary to age-related macular degeneration. Laser treatment of RO-CNV with ICG-V guidance may be successful both anatomically and functionally in a promising number of these otherwise untreatable cases. Further studies are necessary to validate these preliminary findings.
Sorenson
J A
JA
LuEsther T. Mertz Retinal Research Laboratory, Manhattan (NY) Eye, Ear and Throat Hospital.
Yannuzzi
L A
LA
Slakter
J S
JS
Guyer
D R
DR
Ho
A C
AC
Orlock
D A
DA
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000150:complications*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D010865:Pilot Projects; D012008:Recurrence; D014741:Video Recording
D007208:Indocyanine Green