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DM Stanescu, G Coscas, F Coscas, J Uzzan, G Mimoun, W Roquet, G Soubrane; Feeder Vessel Treatment in Age-Related Macular Degeneration (AMD) with Classic, Occult Choroidal Neovascularization and Vascularized Retinal Pigment Epithelium Detachment . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1226.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report on the results of feeder vessel treatment for CNV in AMD . Methods: Retrospective study of 34 patients presenting subfoveal classic (CCNV) and/or occult neovascularization (OCNV) with or without fibrovascular pigment epithelium detachment (PED) based on fluorescein angiography (FA) and on indocyanin green angiography (ICG). Visual acuities were measured on Snellen and/ or ETDRS. The feeder vessels were visualized with a high-speed ICG angiography (confocal scanning laser ophthalmoscope, Heidelberg HRA, Heidelberg, Germany). Feeder vessels (FV) were identified as very thin vessels with an early filling and rapid emptying. FV closure was achieved by laser photocoagulation treatment with either minipulse infrared laser therapy (810 nm) or microburst or yellow laser (568 nm).High-speed ICG angiography control post-treatment was recommended to the patient immediately or the day after the treatment. Number of treatments and the location of the FV to the macula and their results on FA, ICG and visual acuity (VA) were assessed .If necessary other treatment technique such as PDT or TTT were offered to the patient when leakages was still present. Results: The patients were followed for an average of 6.2 months (from 2 months to 9 months). Twenty-two women and 12 men of a mean age of 72 years (ranging from 51 to 95) were included. Five patients demonstrated classic neovascularization, 9 presented occult neovascularization, 16 showed vascularized pigment epithelium and 2 patients had both CCNV and OCNN on FA and ICG. The average number of treatments was 1,8 (ranging from one to four treatments). Location of FV were as follow: 6 supero-macular, 12 infero-macular, 5 naso-macular and 8 temporo-macular. Visual acuity improved ≥ 2 lines in 5 patients (14 %), Visual acuity decreased ≤ 2 lines in 4 patients (11%) and was stable in 25 patients (75 %). X patients after FV treatment had an improvement of the anatomical aspect of the AMD lesions consisting in reduction of the leakage. Except for one subretinal haemorrhage no complications after FV treatment were observed Conclusion: Feeder vessel treatment is a technique, requiring high-speed ICG angiography detecting the feeder vessels located at distance from the subfoveal OCNV, CCNV and PED. Though our results on final visual acuity mainly achieved to stabilization on VA, the technique appeared to be safe and reproducible. In patients non-eligible for other therapies such as PED, FV treatment seemed to be a reasonable alternative
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