Indocyanine green dye-enhanced transpupillary thermotherapy of classic subfoveal choroidal neovascularization.
OBJECTIVE
To evaluate the efficacy of indocyanine green dye-enhanced transpupillary thermotherapy for the treatment of classic subfoveal choroidal neovascular membrane (CNVM) with differing etiologies.


METHODS
Nine eyes of 9 patients with classic subfoveal CNVM with different etiologies that was treated with indocyanine green dye-enhanced transpupillary thermotherapy were prospectively studied. All patients underwent pretreatment fluorescein angiography. Three minutes after dye injection (25 mg of indocyanine green), transpupillary thermotherapy was delivered using a modified diode laser at 810 nm, with a variable spot size of 0.8 to 2 mm depending on the size of the CNVM. A power range between 100 and 800 mW was used and treatment was initiated in one spot for 60 seconds; the end point was a barely detectable light gray appearance of the lesion. The outcome measures were assessed by Snellen visual acuity chart and obliteration of the CNVM by fluorescein angiography. Mean follow-up was 16 months.


RESULTS
Obliteration of the CNVM was seen in all patients during the last visit. Visual acuity improved in one eye and remained stable (+/-2 line change on Snellen chart) in three eyes. Three eyes revealed a moderate visual loss of 3 to 4 lines and two eyes had a severe decline (> 5 lines) in vision. None of the eyes exhibited recurrence of the CNVM during follow-up.


CONCLUSIONS
Indocyanine green dye-enhanced transpupillary thermotherapy was highly effective in closing classic CNVM in all cases without any recurrence. Visual acuity was either stabilized or improved in 4 of 9 eyes (44.5%).
Sharma
Tarun
T
Shri Bihagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Vision Research Foundiation, 18 College Road, Chennai-600 006, India.
Shah
Nitant
N
Gopal
Lingam
L
Shanmugam
Mahesh P
MP
Bhende
Pramod
P
Bhende
Muna
M
Shetty
Nitin S
NS
Sukumar
B
B
D000328:Adult; D000368:Aged; D002829:Choroid / Q000098:blood supply; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000628:therapy*; D004396:Coloring Agents; D005451:Fluorescein Angiography; D005584:Fovea Centralis; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007208:Indocyanine Green; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011680:Pupil; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green