Abstract
Abstract: :
Purpose: To determine how the results of feeder vessel treatment (FVT) depend on the anatomic and flow characteristics of feeder vessels (FVs) in choroidal neovascular membranes (CNVM). Methods: We studied a group of 50 consecutive patients in which FVs could be identified and immediately obliterated using a laser treatment with 532 nm or 810 nm. We used a confocal scanning laser ophthalmoscope (Heidelberg Engineering, Heidelberg, Germany) to perform dynamic indocyanine green angiography (d-ICGA) and dynamic fluorescein angiography (d-FA) in order to characterize FV size, shape, visibility, flow characteristics and location relative to the retinal pigment epithelium. Two independent observers who were masked for visual and anatomic outcomes independently evaluated FV characteristics and treatment results retrospectively. Results: Mean patient age was 71 years old. There were 27 females and 23 males in the treatment group. Lesion size ranged from 80-µm to 125-µm. There were two primary FV classes: (1) linear regular vessels, more common in the occult lesions, and (2) tortuous beading vessels. Flow was considered to be delayed if FVs filled after retinal vessels. Patients with slow-filling, tortuous beading vessels of small size had the best treatment outcomes. Conclusion: The anatomic and flow characteristics of feeder vessels are potentially useful for predicting clinical outcomes in FVT and for optimizing patient selection and treatment strategy.
Keywords: 346 choroid: neovascularization • 432 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 454 laser