Neovascular ingrowth site photothrombosis in choroidal neovascularization associated with retinal pigment epithelial detachment.
OBJECTIVE
To describe the clinical, angiographic and optical coherence tomography (OCT) findings of patients with choroidal neovascularization (CNV) associated with retinal pigment epithelial detachment (PED) who were treated by neovascular ingrowth site photothrombosis.


METHODS
Interventional case reports. After identification of the CNV feeder vessels, two patients had focal photothrombosis of the neovascular ingrowth site using continuous 810-nm laser application after intravenous indocyanine green (ICG) injection and were prospectively followed with fluorescein and ICG angiography as well as OCT.


RESULTS
Both patients presented an increase of 3 or more ETDRS lines in visual acuity by 12 months of follow-up. Fluorescein and ICG angiography demonstrated reduced lesion perfusion and regression of the PEDs; accordingly, OCT disclosed decrease in retinal thickness and elevation caused by rapid fluid resolution. There were no significant complications related to the procedure.


CONCLUSIONS
Photothrombosis using 810-nm light to direct laser energy continuously at the neovascular ingrowth site after intravenous ICG infusion is effective in restoring macular architecture and improving vision in patients with CNV complicated by PEDs by means of substantial decrease in the lesion perfusion and resolution of exudative manifestations.
Costa
Rogério A
RA
Rua Itália 1905, apto 74, Araraquara, SP 14801-350 Brazil. roger.retina@globo.com
Rocha
Karolinne M
KM
Calucci
Daniela
D
Cardillo
José A
JA
Farah
Michel E
ME
D000368:Aged; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000473:pathology; D004396:Coloring Agents / Q000627:therapeutic use*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green / Q000627:therapeutic use*; D007368:Interferometry; D053685:Laser Therapy; D008027:Light; D010778:Photochemotherapy / Q000379:methods*; D010857:Pigment Epithelium of Eye / Q000187:drug effects / Q000473:pathology; D011446:Prospective Studies; D012163:Retinal Detachment / Q000188:drug therapy* / Q000473:pathology; D013927:Thrombosis / Q000209:etiology*; D014054:Tomography
D004396:Coloring Agents; D007208:Indocyanine Green