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A. Polito, D. Roman Pognuz, M.C. Napolitano, P. Lanzetta, F. Bandello; Tomographic assessment of indocyanine green (ICG) guided laser photocoagulation of retinal angiomatous proliferation (RAP) in age–related macular degeneration (AMD) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3104.
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Purpose: to evaluate pre and post–treatment anatomical features of the macula using optical coherence tomography (OCT) in patients who underwent ICG–guided laser photocoagulation for RAP in AMD. Methods: in a noncomparative interventional series, six eyes of 6 patients with AMD and RAP treated with ICG–guided laser photocoagulation were selected for review. All eyes had a clinical diagnosis of RAP based on slit–lamp biomicroscopy, fluorescein and ICG angiography and underwent focal laser photocoagulation to the hot spot detected by ICG angiography. Pre and post–treatment tomograms and angiograms were obtained for all patients. Follow–up ranged from 2 weeks to 6 months, with a median of 14 weeks. Results: OCT showed a typical pattern of structural changes in RAP: increased foveal thickness, cystoid macular edema, serous retinal detachment and a highly reflective intraretinal mass overlying a highly or moderately elevated retinal pigment epithelium. This mass corresponded to the hot spot observed on ICG angiography. After laser photocoagulation, five of the 6 eyes presented a significant decrease in foveal thickness, complete resolution of cystoid macular edema and retinal detachment with thinning of the neurosensory retina overlying the treated area. In these eyes no late leakage could be observed either on fluorescein or ICG angiography on last visit. Median pre–treatment visual acuity was 20/40 (range, 20/100 to 20/32). Median post–treatment visual acuity was 20/32 (range, 20/100 to 20/25). Conclusions: OCT appears to be useful in evaluating and documenting RAP in AMD patients both before and after laser photocoagulation.
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