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RA Costa, ME Farah, JA Cardillo; Selective Choroidal Neovascularization Occlusion Using a Modified Technique of Feeder Vessel Treatment . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2502.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the short term visual and angiographic outcomes after modified technique of feeder vessel (FV) treatment of subfoveal choroidal neovascularization (CNV) utilizing indocyanine green mediated photothermal therapy (PTT) and standard digital indocyanine green angiography (ICGA). Methods: Noncomparative case series. Fourteen eyes of fourteen patients in whom fluorescein and indocyanine green angiography demonstrated feeder vessels supplying the neovascular complex were submitted to selective FV treatment using PTT. Visual acuity assessment, fluorescein and indocyanine green angiography as well as optical coherence tomography (OCT) evaluation were performed within the first 12 hours after treatment to confirm CNV obliteration, and at 1 week, 1 and 3 months follow-up visits. Results: Umbrella-like FV angiographic pattern with subfoveal (n=7) or juxtafoveal (n=3) location was observed in 10 eyes. The remaining 4 eyes demonstrated a racquet-like pattern with laser treatment performed in the foveal (n=2) or juxtafoveal (n=2) area. Fluorescein CNV non perfusion was achieved in all patients within the first 12 hours following PTT. Best corrected visual acuity increased more than 2 lines in 4 patients and by 1 or 2 lines in 5 patients. Stable visual acuity was observed in 5 patients. Decreased retinal thickness due to fluid resolution disclosed by OCT was consistent with angiographic findings and visual function improvement noted 3 months after the initial treatment. There was no significant complication related to the procedure. Conclusion: Modified FV treatment with the use of lower irradiances of 810 nm light application coupled to intravenous high concentration ICG dye bolus induced short term selective CNV hipoperfusion in all treated eyes as demonstrated by fluorescein and ICG angiography. These findings were either consistent with the visual acuity maintenance or improvement observed in all patients as well as with the partial or complete restoration of the retinal architecture observed in OCT evaluation 3 months after PTT. Standard FA and ICGA were sufficient for FV recognition and treatment in these series.
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