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. 1999 Feb;83(2):168-72.
doi: 10.1136/bjo.83.2.168.

Indocyanine green guided laser photocoagulation in patients with occult choroidal neovascularisation

A W Weinberger  1 , H Knabben, U Solbach, S Wolf
Affiliations

Indocyanine green guided laser photocoagulation in patients with occult choroidal neovascularisation

A W Weinberger et al. Br J Ophthalmol. 1999 Feb.

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.

Results: Visual acuity ranged from 20/400 to 20/20 (logMAR 0.54 (SD 0.29) before and hand movements and 20/30 (logMAR 0.81 (0.69)) at the last follow up after laser photocoagulation. During the follow up (30 (13) months) vision improved in four eyes (two lines), in seven eyes the initial visual acuity could be stabilised (two lines), in five eyes vision dropped moderately (three to five lines), and in five eyes vision decreased severely (six or more lines). Recurrences (seven patients) or persistent CNV (six patients) was observed in 13 patients.

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.

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Figures

Figure 1
Figure 1
Cumulative percentage of patients with severe visual loss. Data from the Macular Photocoagulation Study (MPS)13 and from Bressler et al31 for the natural course of occult CNV are included in the diagram.
Figure 2
Figure 2
Scattergram depicting initial and final visual acuity. Points within the dotted lines indicate stabilised visual acuity, points above improved, and points under these lines decreased visual acuity.
Figure 3
Figure 3
Fundus photograph of a patient with occult CNV (FA) and visible neovascular network in the early ICG angiographic study, visual acuity was 20/70.
Figure 4
Figure 4
Fluorescein angiogram of a study patient showing diffuse leakage in the macular area and cystoid macular oedema.
Figure 5
Figure 5
Early phase indocyanine green angiogram reveals a discrete neovascular network above the fovea with a feeding vessel at its nasal superior rim. The white arrows delineate the boarders of the CNV, the dark arrow points to the feeding vessel. Same patient as in Figure 3.
Figure 6
Figure 6
Follow up ICG angiogram 18 months after initial treatment. Visual acuity was 20/200. One re-treatment was performed. Same patient as in Figure 3.
Figure 7
Figure 7
Follow up fluorescein angiogram 18 months after initial treatment. Visual acuity was 20/200. One re-treatment was performed. Same patient as in Figure 3.
Figure 8
Figure 8
Fundus photograph of the patient 18 months after initial laser photocoagulation, visual acuity was 20/200.
See this image and copyright information in PMC

Comment in

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