Enlarged diode laser spot using indirect ophthalmoscope delivery in conjunction with indocyanine green to treat large choroidal neovascularizations.
OBJECTIVE
To evaluate the effectiveness of a new method of delivering diode laser (810 nm) spots through an indirect ophthalmoscope in conjunction with intravenous indocyanine green to treat choroidal neovascularizations (CNVs) larger than 5,400 microm.


METHODS
A prospective, non-comparative, interventional case series study was conducted with 8 patients with CNV secondary to age-related macular degeneration. Laser pulses were applied to the CNV within 5 minutes of an intravenous injection of 25 mg of indocyanine green. The laser spot was enlarged up to one disc diameter by shortening the distance between the indirect ophthalmoscope and the 20-diopter viewing lens. The follow-up period was 3 months.


RESULTS
Three eyes had an improvement in visual acuity of more than 2 lines, and fluorescein angiography showed stabilization of the membrane and reduction of the hemorrhages and subretinal fluid at the last follow-up. Three other eyes maintained the same visual acuity and two had a decrease in visual acuity of more than 2 lines at the 3-month follow-up examination.


CONCLUSIONS
Laser treatment delivered through an indirect ophthalmoscope system may be used as a palliative treatment for CNVs larger than 5,400 microm.
Reategui-Escalante
Guillermo
G
Hospital Dr. Luis Sánchez Bulnes de la Asociación Para Evitar la Ceguera en México, San Lucas Coyoacan, Mexico.
Murillo-Lopez
Sergio A
SA
Romero-Castro
Rosa M
RM
Suarez-Tata
Luis M
LM
Guerrero-Naranjo
Jose L
JL
Quiroz-Mercado
Hugo
H
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D007275:Injections, Intravenous; D017075:Laser Coagulation / Q000295:instrumentation / Q000379:methods*; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019721:Ophthalmoscopes; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green