Indocyanine green-mediated photothrombosis as a new technique of treatment for persistent central serous chorioretinopathy.
OBJECTIVE
To evaluate the potential benefit and complications of indocyanine green-mediated photothrombosis (IMP) in the management of patients with persistent central serous chorioretinopathy (CSC).


METHODS
Interventional noncomparative case series. Eleven patients with CSC presenting with persistent subretinal fluid in optical coherence tomography (OCT) four months after presentation and decrease in visual acuity (VA) were submitted to a single IMP session with 2 mg/kg body weight ICG and application of 5.6 W/cm(2) light at 810 nm. A continuous follow-up was provided with best-corrected ETDRS VA assessment, and angiographic and OCT documentation 72 hours before and at 2 days, 1 and 2 weeks, 1, 3, 6, and 12 months after treatment.


RESULTS
Pretreatment VA levels ranged from 20/32 - 1 to 20/100 (mean, 20/63 + 2 [logMAR equivalent, 0.460 +/- 0.155]); post treatment levels ranged from 20/25 - 2 to 20/20 (mean, 20/20 - 2 [logMAR equivalent, 0.038 +/- 0.048]). Ten out of eleven patients presented with VA levels of >/=20/25 2 weeks after treatment; the mean logMAR VA change of 0.345 at that time was statistically significant (p < 0.05, Friedman test). OCT disclosed resolution of persistent subretinal fluid in all eyes. No recurrence was observed after 12 months of follow-up. Complications included transient retinal whitening in two patients, and associated occlusion of retinal capillaries in one.


CONCLUSIONS
Photothrombosis using low-intensity 810 nm light to direct laser energy continuously at the active leakage sites after intravenous ICG infusion induced rapid VA recovery in patients with persistent CSC; accordingly, restoration of the macular architecture was evidenced on OCT, and no recurrence was noted 12 months after IMP.
Costa
Rogério A
RA
Instituto da Visão--IPEPO, Department of Ophthalmology, Federal University of São Paulo, Brazil. roger.retina@globo.com
Scapucin
Luciana
L
Moraes
Nilva S
NS
Calucci
Daniela
D
Melo
Luiz A
LA
Cardillo
José A
JA
Farah
Michel E
ME
D000328:Adult; D002199:Capillary Permeability; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy*; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green / Q000627:therapeutic use*; D008268:Macular Degeneration / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D010857:Pigment Epithelium of Eye / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy; D013927:Thrombosis / Q000209:etiology; D014054:Tomography; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology
D007208:Indocyanine Green