Photodynamic therapy with indocyanine green for occult subfoveal choroidal neovascularization caused by age-related macular degeneration.
OBJECTIVE
To report two cases of occult subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) that were successfully treated utilizing large spot, low irradiance 810-nm light and intravenous injection of small-volume, high-concentration indocyanine green (ICG) bolus, termed ICG-mediated photodynamic therapy (i-PDT).


METHODS
Case report. Two patients with occult subfoveal CNV (two eyes) due to AMD were treated with i-PDT and were prospectively followed with fluorescein and indocyanine green angiography as well as optical coherence tomography (OCT).


RESULTS
Both patients presented a 3-line increase in visual acuity by twelve months of follow-up. A significant regression of the CNV was demonstrated by fluorescein angiography within one week following treatment. OCT revealed diminishing of the subretinal fluid. There were no complications related to the procedure.


CONCLUSIONS
i-PDT induced CNV regression and improved the visual acuity in these particular cases, suggesting a new and promising way to treat neovascular AMD. The partial anatomical restoration associated to the improvement of the visual function observed in both patients suggests that a selective therapeutic effect was achieved. Further studies are required not only to assess the clinical value of this treatment but also to better understand the major mechanism of action involving this novel treatment modality.
Costa
R A
RA
Department of Ophthalmology, Federal University of São Paulo, Paulista School of Medicine, São Paulo, Brazil.
Farah
M E
ME
Cardillo
J A
JA
Belfort
R
R
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D005451:Fluorescein Angiography; D005584:Fovea Centralis / Q000098:blood supply*; D006801:Humans; D007208:Indocyanine Green / Q000627:therapeutic use*; D007275:Injections, Intravenous; D007368:Interferometry; D008027:Light; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D014054:Tomography; D016896:Treatment Outcome; D014792:Visual Acuity
D017319:Photosensitizing Agents; D007208:Indocyanine Green