title: Indocyanine green-guided laser photocoagulation of focal spots at the edge of plaques of choroidal neovascularization.
abstract: 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.
authors.affiliation: Retinal Research Laboratory, Manhattan Eye, Ear & Throat Hospital, New York, NY, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Guyer
authors.forename: L A
authors.initials: LA
authors.lastname: Yannuzzi
authors.forename: I
authors.initials: I
authors.lastname: Ladas
authors.forename: J S
authors.initials: JS
authors.lastname: Slakter
authors.forename: J A
authors.initials: JA
authors.lastname: Sorenson
authors.forename: D
authors.initials: D
authors.lastname: Orlock
mesh_terms: 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
chemical_list: D007208:Indocyanine Green