May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Results of A One Year Study of Choroidal Feeder Vessel Therapy in Age Related Macular Degeneration
Author Affiliations & Notes
  • G. Staurenghi
    Department of Clinical Science, University of Milan, Milano, Italy
  • G. Levi
    Department of Clinical Science, University of Milan, Milano, Italy
  • P. Danzi
    Dipartimento di Specialita  Chirurgiche, Scienze Radiologiche e Medico-Forensi, University of Brescia, Brescia, Italy
  • R. Flower
    University of Mariland, Baltimore, Maryland
    New York University, New York, New York
  • C. Veronese
    Department of Clinical Science, University of Milan, Milano, Italy
  • Footnotes
    Commercial Relationships G. Staurenghi, Novadaq, F; Novadaq, R; G. Levi, Novadaq, R; P. Danzi, Novadaq, R; R. Flower, Novadaq, C; C. Veronese, Novadaq, E.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 1453. doi:
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    • Get Citation

      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.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: 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).

Methods:: 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.

Results:: 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.

Conclusions:: 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.

Keywords: age-related macular degeneration • choroid: neovascularization • laser 
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