Indocyanine green-mediated photothrombosis combined with intravitreal triamcinolone for the treatment of choroidal neovascularization in serpiginous choroiditis.
OBJECTIVE
To report a case of peripapillary choroidal neovascularization (CNV) complicating serpiginous choroiditis that was treated by a single indocyanine green (ICG)-mediated photothrombosis session combined to intravitreous triamcinolone acetonide (TA) injection.


METHODS
Interventional case report. A 48-year-old patient with peripapillary CNV was submitted to a laser-dye-mediated technique that uses ICG and low-intensity 810-nm light for continuous laser application; TA was then injected into the vitreous cavity 1 hour later, and prospective evaluation with fluorescein and ICG angiography as well as optical coherence tomography (OCT) was performed.


RESULTS
At 2 weeks after treatment, best-corrected visual acuity improved from 20/200 to 20/50, with further improvement to 20/20-1 in the subsequent 10 weeks. Absence of fluorescein leakage from the CNV and OCT evidence of resolved retinal oedema was observed at that time. Clinical stabilization was maintained up to 1 year of follow-up. There was no significant complication related to the procedure.


CONCLUSIONS
Combined ICG-mediated photothrombosis and intravitreous TA induced rapid and significant visual acuity recovery in this particular case of peripapillary CNV complicating serpiginous choroiditis. Accordingly, angiographic and OCT findings demonstrated neovascular lesion regression and restoration of the macular architecture.
Navajas
E V
EV
Department of Ophthalmology Instituto da Visão - IPEPO Federal University of São Paulo Brazil.
Costa
R A
RA
Farah
M E
ME
Cardillo
J A
JA
Bonomo
P P
PP
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D020256:Choroidal Neovascularization / Q000150:complications / Q000628:therapy*; D002833:Choroiditis / Q000150:complications / Q000628:therapy*; D004396:Coloring Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D007208:Indocyanine Green / Q000627:therapeutic use; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D014221:Triamcinolone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D004396:Coloring Agents; D017319:Photosensitizing Agents; D014221:Triamcinolone; D007208:Indocyanine Green