Indocyanine Green Mediated Photothrombosis for Choroidal Neovascularization in Angioid Streaks

Abstract

Abstract: : Purpose: To report the outcome of indocyanine green mediated photothrombosis (iMP) in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks. Methods: One center prospective interventional case series. Patients received iMP at baseline with retreatment as necessary at 3, 6 and 9 months follow up. Best–corrected visual acuity (BCVA) was obtained using ETDRS charts; fluorescein leakage was evaluated at 3, 6 and 9 month visits, along with foveal thickness measured by Stratus OCT. Treatment was indicated if CNV was considered to be active, according to evidence of fluorescein leakage at angiograms or presence of intraretinal or subretinal fluid on OCT. Treatment was indicated regardless of classic or occult patterns of CNV. All eyes had subfoveal CNV. Retreatment was performed whenever there was evidence of increased leakage on fluorescein angiograms at follow up visits.Results: Six eyes of 5 patients were recruited, 3 males and 2 females. Two eyes underwent retreatment. Patients had at least 3 month follow up. Four eyes had improvement in BCVA; two had decrease in BCVA. All patients showed less fluorescein leakage at angiograms. All patients showed foveal thickness reduction as measured by OCT. Follow up time was 13 to 60 weeks, averaging 35.5 weeks. Retinal pigment epithelium (RPE) atrophy after treatment was observed in two eyes.Conclusions: iMP is a feasible procedure for CNV secondary to angioid streaks. Lesion analysis showed improvement of anatomical parameters in this small series. Further studies are warranted to evaluate the long term results of this rather inexpensive treatment and to elucidate the causes for RPE atrophy.

Keywords: choroid: neovascularization • clinical (human) or epidemiologic studies: systems/equipment/techniques • laser