Purchase this article with an account.
G. Staurenghi, G. Levi, P. Danzi, R. Flower, C. Veronese; Results of A One Year Study of Choroidal Feeder Vessel Therapy in Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1453.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the safety and effectiveness of choroidal feeder vessel (FV) closure in the presence of indocyanine green (ICG) using a modified fundus camera for treatment of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
The study was a single center, prospective, randomized controlled open-label parallel group study with 2 treatment arms.Patients with FV associated with CNV were randomized into 1 of 2 treatment arms: 1 patients was treated by choroidal FV photocoagulation during ICG dye transit (FVT + ICG), the other was treated by FV photocoagulation without ICG (Control). Both treatment arms used a diagnostic/treatment system able to visualize and apply laser during ICG transit. The patients were followed and/or treated at 2, 4, 8, 12 weeks, and 6 months; with 1 additional follow up at 12 months post first treatment.
Forty patients were enrolled (20 Control/20 FVT+ICG), with 38 patients (18 Control/20 FVT+ICG) receiving at least 1 treatment with this device. The study demonstrated that the device was easy to use, and treatment session times decreased with experience with the System. The entire diagnostic, treatment and post-treatment confirmation ICG angiography took 21 to 23 minutes; this was similar for both treatment arms. On average, 4 - 5 treatment sessions were required for complete treatment in both arms over the course of the study. On average, the FVT+ICG arm used about 7 times less energy/treatment session than the Control arm (5.7 J/treatment session versus 38.9J/treatment session). Importantly, treatment was more effective and more durable in the FVT+ICG arm, as 90% of the patients were able to have their choroidal FVs closed or partially closed, with 70% of those vessels remaining closed at the last treatment assessment, compared to 77% and 44%, respectively, in the Control arm. During the course of the study, 45% fewer patients in the FVT+ICG arm went on to require alternative treatments for their wet AMD than patients in the Control arm.
Data analysis suggests that feeder vessels are identifiable and treatable during the dye transit. Treatment with ICG appears to be a safe procedure. Moreover, FV photocoagulation with ICG present in the target vessel, produced a more effective and more durable treatment outcome than photocoagulation using laser only.
This PDF is available to Subscribers Only