[Laser photocoagulation of occult choroidal neovascularization guided by angiography using indocyanine green. A pilot study].
OBJECTIVE
Age related macular degeneration (AMD) is the most common cause of legal blindness in the Western world in people over 50 years of age. The most severe visual loss occurs in patients with AMD complicated by choroidal neovascular membranes (CNV). Indocyanine green angiography (ICG) account for visualization in up to 60% of the cases that are classified as occult on fluorescein angiography (up to 70% of the cases). ICG-guided laser photocoagulation of CNV is currently a mater of debate. We conducted a pilot study to determine wether it could be beneficial for patients presenting with occult CNV on fluorescein angiography.


METHODS
Twenty consecutive patients (20 eyes) with occult CNV in AMD were included. All showed occult CNV on fluorescein angiography and a well defined juxta- or extrafoveal hot spot or plaque hyperfluorescence on ICG. Fibrovascular retinal pigment epithelial detachments were excluded. The patients had serial controls, including fluorescein angiography and ICG, at 15 days, 1, 2, 3, 6, 9 and 12 months after photocoagulation.


RESULTS
At the end of follow-up visual acuity (VA) was stable (within +/- 3 lines) compared to the initial one in 80% (16) of the cases. A complete resolution of exudative signs was observed in 75% (15) of the cases.


CONCLUSIONS
ICG-guided laser photocoagulation of occult CNV in AMD account for better visual acuity than natural course of the disease at 12 months follow-up. However, a prospective randomized clinical trial is warranted to evaluate definitively this treatment approach.
Donati
G
G
Clinique Universitaire d'Ophtalmologie de Genève, Département des Neurosciences cliniques, Hôpitaux Universitaires de Genève, 1211 Genève 14, Suisse.
Kapetanios
A D
AD
Pournaras
C J
CJ
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply* / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005456:Fluorescent Dyes; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000601:surgery*; D010865:Pilot Projects
D005456:Fluorescent Dyes; D007208:Indocyanine Green