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Y. Usui, Y. Hirano, M. Nozaki, T. Yasukawa, Y. Ogura; Indocyanine Green Angiography-Guided Laser Photocoagulation for Idiopathic Macular Telangiectasia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):218.
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As reported previously, while laser photocoagulation was effective for type I (aneurysmal) telangiectasia, type II (perifoveal) telangiectasia was refractory to laser photocoagulation. The reason was because focal targets such as aneurysms were not detectable by fluorescein angiography (FA) in eyes with type II telangiectasia. We evaluated the efficacy of indocyanine green angiography (IA)-guided laser photocoagulation combined with subtenon injection of triamcinolone acetonide (STTA) for idiopathic macular telangietasia.
Seven eyes of 7 patients were enrolled in this study. Two patients were male: 5 patients female. The mean age was 72 years, ranging 50-82 years. Two were classified into type I, and 5 eyes type II. Mean follow-up period was 8.0 (ranged 4-16) months. FA and IA were performed with Heidelberg Retina Angiogram 2. Laser photocoagulation targeted leaky vessels detected by IA, carried out with the following settings: wavelength of 577 nm, power of 100-200 mW, spot size of 100-200 µm, and duration of 0.2 sec. Immediately after photocoagulation, STTA (20 mg) was performed. Central macular thickness was periodically measured by optical coherence tomography. Logarithm of the minimum angle of resolution (LogMAR) visual acuity was also measured.
At the final visit, the mean central macular thickness and the mean visual acuity were improved significantly from baseline (p<0.05). Visual acuity was improved with 0.3 or more of LogMAR units in 2 eyes (29 %), stabilized in 5 eyes (71 %), and deteriorated in no eyes (0%). No adverse effects were reported throughout the observation period.
IA was helpful to detect microangiopathy even in eyes with type II telangiectasia. ICG-guided laser photocoagulation combined with STTA might be effective to treat not only type I but also type II idiopathic macular telangiectasia.
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