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M. Zanotele, D. Calucci, J.A. Cardillo, M.E. Farah, R.A. Costa; Management of Choroidal Neovascularization Associated with Retinal Choroidal Anastomosis Using Indocyanine Green-mediated Photothrombosis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4061.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the visual and angiographic effects as well as optical coherence tomography (OCT) findings after a new treatment, indocyanine green (ICG)-mediated photothrombosis, in patients with choroidal neovascularization (CNV) associated to retinal choroidal anastomosis (RCA). Methods: Prospective noncomparative small case series. Eight eyes of seven patients with CNV, in whom fluorescein and ICG angiography clearly demonstrated distinct retinal vessels supplying the neovascular complex, were submitted to ICG-mediated photothrombosis. This novel, laser-dye-mediated technique uses large-spot, lower intensity 810-nm light for continuous application of laser energy to photoactivate ICG concentrated in vascular lesions. Results: Substantial obliteration of the neovascular lesion was achieved in all patients within the first week following ICG-mediated photothrombosis. Best-corrected visual acuity increased more than 3 lines in five eyes, remained stable in two, and decreased by 3 lines in one. Decreased leakage of fluorescein from the CNV as well as OCT evidence of reduced or resolved retinal edema was observed 12 months after treatment in all but one patient. Retinal pigment epithelial tear was observed in one patient. Conclusions: Neovascular photothrombosis using lower-intensity 810nm light and intravenous ICG infusion is an effective technique for rapid induction of CNV hypoperfusion in selected patients with associated RCA. Vision stabilization or improvement occurred in 87.5% of the cases 12 months after treatment; accordingly, OCT disclosed considerable resolution of the exudative manifestations at last follow-up.
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