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G. Levi, P. Danzi, C. Veronese, R. Flower, G. Staurenghi; Dye–Enhanced Photocoagulation (DEP) for Treatment of Choroidal Neovascularization in Age–Related Macular Degeneration: Interim, Preliminary Data From an On–Going Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):292.
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Purpose: To compare efficacy of choroidal neovascular membrane (CNV) feeder vessel treatment (FVT) preformed by application of 810 nm laser energy during indocyanine green (ICG) dye transit through the feeder vessels (i.e., DEP) to application of the laser energy alone. Methods: A fundus camera was modified for ICG angiography by replacing its xenon flash lamp with an 810 nm wavelength diode laser. Live ICG images were acquired by a CCD video camera and displayed on a LCD monitor located above the patient’s eye. The output fiber optic of an 810 nm laser photocoagulator was mounted on a joystick–controlled micromanipulator in the fundus camera’s optical system for positioning the photocoagulator laser beam on the fundus while viewing live ICG video images of the choroidal vasculature. The device makes possible precise delivery of photocoagulation energy to CNV FVs upon arrival of a secondarily–injected, high–concentration ICG dye bolus in a targeted FV. Patients are randomized to ICG–DEP FVT or FVT alone. Results: 24 patients randomized to date (12 FVT / 12 ICG–DEP FVT). Data at 6 months are consistent with published outcomes for overall FVT vessel closure, but there were differences related to the FVT method applied: 83% closed in the ICG–DEP FVT arm, 64% closed in the FVT only arm. The number of laser burns to achieve the closure with DEP FVT were less than FVT (3 to 9 vs. 100 to 300). Conclusions: Preliminary data analysis suggests that feeder vessels are identifiable and treatable during the dye transit. ICG–DEP appears to facilitate FVT by reducing the number of burns necessary for vessel closure and makes the treatment of larger diameter new vessels possible.
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