A pilot study of ICG-guided laser photocoagulation for occult choroidal neovascularization presenting as a focal spot in age-related macular degeneration.
OBJECTIVE
To evaluate the effect of indocyanine green angiography (ICG)-guided laser photocoagulation in eyes with age-related macular degeneration (AMD) and occult choroidal neovascularization (O-CNV), appearing as a well-defined focal spot on ICG.


METHODS
Eyes with extrafoveal or juxtafoveal focal spot on ICG, either without PED (Group A) or with PED (Group B) at baseline, were selected. The hyperfluorescent area was photocoagulated by krypton red laser within 24 hours from diagnosis on ICG guide. At 1, 3, 6, 9 and 12 months from treatment, all eyes underwent clinical examination, FA and ICG. Parameters as best corrected visual acuity (BCVA), CNV closure and recurrence onset were analyzed.


RESULTS
53 eyes were enrolled in Group A and 33 in Group B. After 1 year from treatment, a stabilized (+/-1 Snellen line) or improved (2 or more Snellen lines) visual acuity was measured in 37 eyes (43%), 32 in Group A and 5 in Group B. After 1 year, a complete resolution of exudative signs was achieved with one or more laser sessions in 41 eyes (48%), 34 in Group A and 7 in Group B. After 1 year, 50 eyes (58%) had one or more episodes of recurrent CNV, appearing in 51% of eyes of Group A and in 70% of eyes of Group B. Most of the recurrences (86%) occurred during the first trimester after photocoagulation.


CONCLUSIONS
ICG-guided laser photocoagulation for O-CNV appearing as a focal spot produced encouraging anatomical and functional outcome in eyes without PED at presentation. When focal CNV is associated with a PED, our treatment technique produced disappointing results.
Da Pozzo
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Eye Clinic of the University, Piazza dell'Ospedale 1, 34129 Trieste, Italy.
Parodi
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MB
Ravalico
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D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000601:surgery*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation / Q000379:methods*; D008268:Macular Degeneration / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green