A pilot study of digital indocyanine green videoangiography for recurrent occult choroidal neovascularization in age-related macular degeneration
J. A. Sorenson, L. A. Yannuzzi, J. S. Slakter, D. R. Guyer, A. C. Ho and D. A. Orlock
LuEsther T. Mertz Retinal Research Laboratory, Manhattan (NY) Eye, Ear and Throat Hospital.
PURPOSE: Digital indocyanine green videoangiography (ICG-V) was used to
study recurrent choroidal neovascularization (CNV) in patients with the
clinical and fluorescein angiographic findings indicative of ill-defined,
or recurrent occult, CNV (RO-CNV). The use of ICG-V-guided laser
caphotocoagulation as an alternative form of treatment was also
investigated when a well-delineated area of CNV was imaged with this
technique. METHODS: A consecutive series of 66 patients were studied who
presented with exudative age-related macular degeneration and symptoms and
clinical manifestations of recurrent CNV in which fluorescein angiography
did not reveal classic, or well-defined, neovascularization. Patients were
selected for laser treatment based on conventional guidelines if ICG-V
imaged a well-delineated area of recurrent CNV. RESULTS: Indocyanine green
videoangiography showed late staining that was consistent with recurrent
CNV in 64 (97%) of these 66 patients with RO-CNV. Twenty-nine (44%) of the
66 were eligible for laser treatment, and 18 (62%) of these 29 patients
experienced successful anatomic and visual results, which were defined as
resolution of the exudative manifestations and improvement or stabilization
(+/- 1 line on a Snellen chart) of vision. CONCLUSIONS: This pilot study
suggests that ICG-V is of value in imaging patients with RO-CNV after laser
photocoagulation for CNV secondary to age-related macular degeneration.
Laser treatment of RO-CNV with ICG-V guidance may be successful both
anatomically and functionally in a promising number of these otherwise
untreatable cases. Further studies are necessary to validate these
preliminary findings.
