Indocyanine green-guided laser photocoagulation of focal spots at the edge of plaques of choroidal neovascularization
D. R. Guyer, L. A. Yannuzzi, I. Ladas, J. S. Slakter, J. A. Sorenson and D. Orlock
Retinal Research Laboratory, Manhattan Eye, Ear & Throat Hospital, New York, NY, USA.
OBJECTIVE: To determine whether indocyanine green-guided laser
photocoagulation of focal spots at the edge of plaques of
neovascularization is beneficial for patients with untreatable occult
choroidal neovascularization by fluorescein imaging. PATIENTS: A pilot
series of 23 eyes were identified that had untreatable occult choroidal
neovascularization secondary to age-related macular degeneration with focal
spots at the edge of a plaque of neovascularization on the indocyanine
green study. After informed consent was obtained, indocyanine green-guided
laser photocoagulation was applied solely to the focal spot at the edge of
the plaque. RESULTS: Anatomical success with resolution of the exudative
findings was noted in 15 (79%) of 19 eyes at 6 months, 13 (68%) of 19 eyes
at 12 months, and six (37.5%) of 16 eyes at 24 months. The median follow-up
period was 18 months (range, 3 to 44 months). Visual acuity was stabilized
or improved in nine (69%) of 13 successfully treated eyes at 1 year. Of the
successfully treated cases at 1 year, nine (69%) of 13 had a final visual
acuity of 20/100 or better. CONCLUSIONS: Our preliminary study of
indocyanine green-guided laser photocoagulation of focal spots at the edge
of plaques of neovascularization suggests that this technique may improve
the visual prognosis of these patients with presently untreatable disease.
A prospective, randomized, controlled clinical trial is warranted to
evaluate this treatment approach.
