Retina-sparing laser treatment of occult CNV by vitrectomy and localised detachment of the macula.
BACKGROUND
Occult choroidal neovascularisation (CNV) was treated by a novel surgical approach. In order to spare the retina during laser photocoagulation of occult CNV, the retina was detached by subretinal infusion of a ringer solution. After localised detachment of the neural retina the CNV was transretinally coagulated by an endoprobe of a diode laser.


METHODS
Twelve patients with occult CNV were treated in such a way. The mean duration of follow-up was 3.5 +/- 1.6 months. After 4 weeks fluorescein angiography and indocyanine green angiography were performed in all patients. Laser exposure time was 1.1 +/- 0.7 s and laser energy was 1.2 +/- 0.7 W.


RESULTS
In 10 of 12 patients the retina could be successfully detached and performed. In all cases the retina remained unchanged during laser photocoagulation. After 5 days subtle RPE atrophy and after 1 month obvious RPE atrophy was found. After 4 weeks, in 8 of 10 cases the CNV was completely occluded and no late leakage was found. Three months after operation, retinal atrophy could be seen in all cases. Visual acuity was lower in 6 and unchanged in 4 of 10 patients.


CONCLUSIONS
Despite acute sparing of the neural retina the long-term effects are not better than after conventional laser photocoagulation, because secondary atrophy of the retina develops.
Roider
J
J
Department of Ophthalmology, University of Regensburg, Germany. roider@eye-regensburg.de
D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D020256:Choroidal Neovascularization / Q000209:etiology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation / Q000379:methods*; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D012160:Retina / Q000473:pathology; D012163:Retinal Detachment / Q000601:surgery; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D007208:Indocyanine Green