Indocyanine green-guided laser photocoagulation of focal spots at the edge of plaques of choroidal neovascularization.
OBJECTIVE
To determine whether indocyanine green-guided laser photocoagulation of focal spots at the edge of plaques of neovascularization is beneficial for patients with untreatable occult choroidal neovascularization by fluorescein imaging.


METHODS
A pilot series of 23 eyes were identified that had untreatable occult choroidal neovascularization secondary to age-related macular degeneration with focal spots at the edge of a plaque of neovascularization on the indocyanine green study. After informed consent was obtained, indocyanine green-guided laser photocoagulation was applied solely to the focal spot at the edge of the plaque.


RESULTS
Anatomical success with resolution of the exudative findings was noted in 15 (79%) of 19 eyes at 6 months, 13 (68%) of 19 eyes at 12 months, and six (37.5%) of 16 eyes at 24 months. The median follow-up period was 18 months (range, 3 to 44 months). Visual acuity was stabilized or improved in nine (69%) of 13 successfully treated eyes at 1 year. Of the successfully treated cases at 1 year, nine (69%) of 13 had a final visual acuity of 20/100 or better.


CONCLUSIONS
Our preliminary study of indocyanine green-guided laser photocoagulation of focal spots at the edge of plaques of neovascularization suggests that this technique may improve the visual prognosis of these patients with presently untreatable disease. A prospective, randomized, controlled clinical trial is warranted to evaluate this treatment approach.
Guyer
D R
DR
Retinal Research Laboratory, Manhattan Eye, Ear & Throat Hospital, New York, NY, USA.
Yannuzzi
L A
LA
Ladas
I
I
Slakter
J S
JS
Sorenson
J A
JA
Orlock
D
D
D000368:Aged; D002829:Choroid / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation / Q000379:methods*; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D009389:Neovascularization, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010865:Pilot Projects; D014792:Visual Acuity
D007208:Indocyanine Green