Feeder vessel photocoagulation of subfoveal choroidal neovascularization secondary to age-related macular degeneration.
OBJECTIVE
This study aimed to assess the feasibility of laser photocoagulation of feeder vessels of subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration.


METHODS
Of 170 consecutive patients with subfoveal CNV secondary to age-related macular degeneration, feeder vessels were detected in 37 patients by means of indocyanine green videoangiography using a scanning laser ophthalmoscope. Dye laser photocoagulation was applied to extrafoveal feeder vessels, with the fovea spared.


RESULTS
Twenty-six (70%) of those 37 patients had complete resolution of exudative manifestations. Persistent or worsened manifestations were seen in 11 patients (30%) because of recurrent CNV or persistent CNV. The visual acuity improved or stabilized in 25 patients (68%). Ten patients (27%) had a final visual acuity of 20/40 or better and six patients (16%) had a final visual acuity of 20/50 to 20/100. Significant factors prognostic of the visual outcome of 20/100 or better were small CNV (2 disc areas or smaller, Fisher's exact probability test, P = 0.041), the absence of white, fibrous tissue in neovascular membranes (Fisher's exact probability test, P = 0.003), and the closest distance of laser burns to the center of the foveal avascular zone (Fisher's exact probability test, P = 0.049). Preoperative visual acuity had a significant positive correlation with final visual acuity (Spearman's rank correlation test, P = 0.0076).


CONCLUSIONS
Feeder vessel photocoagulation should be considered as a treatment option for subfoveal CNV secondary to age-related macular degeneration, because no other treatment method has a better visual outcome.
Shiraga
F
F
Department of Ophthalmology, Okayama University Medical School, Japan.
Ojima
Y
Y
Matsuo
T
T
Takasu
I
I
Matsuo
N
N
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D005240:Feasibility Studies; D005260:Female; D005451:Fluorescein Angiography; D005456:Fluorescent Dyes; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000098:blood supply*; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D014792:Visual Acuity
D005456:Fluorescent Dyes; D007208:Indocyanine Green