Indocyanine green guided laser photocoagulation in patients with occult choroidal neovascularisation

Abstract

Aims-To determine whether indocyanine green (ICG) guided laser photocoagulation of occult choroidal neovascularisations (OCNV) is beneficial for patients with occult choroidal neovascularisation secondary to age related macular degeneration (AMD). Methods-A prospective pilot study was performed in 21 eyes with OCNV secondary to AMD that could be identified extrafoveolarly or juxtafoveolarly in an early ICG angiographic study. Laser photocoagulation was applied to the neovascular membrane identified in the early ICG angiographic study. Conclusion-This preliminary study of ICG guided laser photocoagulation of occult extrafoveal and juxtafoveal choroidal neovascularisations suggests that this technique may improve the visual prognosis of these patients. Further prospective controlled studies are necessary to confirm these data. (Br J Ophthalmol 1999;83:168-172) Age related macular degeneration (AMD) is the most common cause of vision loss in the Western world. Results-Visual

Angiographic findings in patients with exudative age-related macular degeneration

“…Recently, ICG-guided laser photocoagulation has been proposed for patients with occult CNV and a visible capillary network in the early ICG angiograms. It has been suggested that patients benefit from laser photocoagulation of occult CNV which are visible in the early ICG-angiographic study [27]. In our study, only 10 eyes with occult CNV and a distinct capillary network had a juxta-or extrafoveal lesion and were treated by ICGguided laser photocoagulation.…”

“…ICG angiography has been suggested to be a valuable tool in identifying occult CNV and converting them into visible CNV, either as neovascular capillary network in the early-phase angiogram or as plaque-like hyperfluorescence in the late-phase angiogram.. [12,28,29,31]. We were especially interested in the proportion of eyes with a neovascular capillary network in the early-phase angiogram since these eyes may be eligible for laser photocoagulation [27]. In this study we were able to visualize a distinct neovascular network in 50 eyes (29%) of the occult group.…”

Susceptibility to ocular autoimmune disease

“…Indications for treatment, visual prognosis, and recurrence rate in these three CNV morphological types are quite diVerent. 2 Furthermore, a marked disproportion between eyes with pigment epithelial detachment (PED) (two cases) and those without PED (the remaining 19), not reflecting the data provided by Guyer and colleagues in 1000 consecutive eyes, 3 characterises the examined population. The authors present the final anatomical and visual outcomes by considering all eyes as a single group; this method is questionable, since vascularised PED and RPE are definitely two distinct entities.…”

ICG-guided laser photocoagulation of juxtafoveal and extrafoveal occult choroidal neovascularization

“…ICG-guided laser photocoagulation has recently been proposed as a new treatment modality for occult CNV in AMD [6,8,9,[24][25][26][27][28]. We conducted a prospective pilot study to evaluate the functional and anatomical results of ICG-guided laser photocoagulation of juxta-and extrafoveal occult CNV appearing as late-phase fluorescein leakage of an undetermined source.…”