Abstract
Abstract: :
Purpose: To evaluate prospectively the effectiveness and limitations of a new method of diode laser (810 nm) delivery with the indirect ophthalmoscope, in conjunction with intravenous indocyanine green (ICG) to treat choroidal neovascularization (CNV). The proposed method may improve or stabilize vision, and reduce subretinal fluid. Methods: Patients with occult CNV secondary to age-related macular degeneration (ARMD) diagnosed clinically and by fluorescein angiography, that were not candidates for photodynamic therapy or refused it were included. 25 mg of ICG were injected intravenously. Transpupillary laserpulses were applied to the CNV within the next 5 minutes after injection, enlarging the laser spot up to one disc diameter by shortening the distance between the indirect ophthalmoscope and the 20D lens (aproximately 30 cm). Based on prior studies on pigmented rabbit retina, the energy applied was 200 to 500 mw for 60 seconds. Minimum follow-up was 3 months. Results: Eight eyes of eight patients were treated in this study. Four patients maintained or improved visual acuity and four experimented a moderate diminishment of visual acuity. Fluorescein angiography showed stabilization of the membrane and reduction in hemorrhage and subretinal fluid. Conclusion: Laser delivery and enlargement of laser spot with indirect ophthalmoscope is a method which could prove useful for the dye-assisted treatment of CNV.
Keywords: 308 age-related macular degeneration • 346 choroid: neovascularization • 454 laser