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April 1994

A Pilot Study of Indocyanine Green Videoangiography-Guided Laser Photocoagulation of Occult Choroidal Neovascularization in Age-Related Macular Degeneration

Author Affiliations

From the Retinal Research Laboratory, Manhattan Eye, Ear, and Throat Hospital, New York, NY. Dr Yannuzzi is a member of the board of Akorn Inc, Abita Springs, La, which distributes indocyanine green dye. None of the authors has any financial involvement with Topcon Inc, Paramus, NJ. None of the authors has incurred any financial or proprietary gain by the sale and distribution of indocyanine green dye or the imaging systems described in this article.

Arch Ophthalmol. 1994;112(4):465-472. doi:10.1001/archopht.1994.01090160041020

Purpose:  To evaluate the use of digital indocyanine green videoangiography in patients with clinical and fluorescein angiographic evidence of "occult" choroidal neovascularization in age-related macular degeneration and to investigate indocyanine green videoangiography-guided laser photocoagulation as a therapeutic approach.

Methods:  Three hundred forty-seven consecutive patients with exudative age-related macular degeneration and symptoms and clinical manifestations of occult choroidal neovascularization were studied with indocyanine green videoangiography. Patients were selected for laser treatment, using conventional guidelines, when indocyanine green videoangiography demonstrated a well-delineated area of hyperfluorescence, presumed to be a focal area of choroidal neovascularization.

Results:  Seventy-nine (23%) of 347 eyes were found to have a localized and definable lesion that was potentially amenable to laser photocoagulation therapy; 44 (56%) of these 79 treated eyes had complete resolution of their exudative manifestations. Visual acuity improvement was noted in 10 (13%) of 79 eyes, and stabilization of vision achieved in 42 eyes (53%).

Conclusion:  Laser photocoagulation treatment guided by indocyanine green videoangiography was shown to produce promising anatomical and visual improvement in a small number of patients with occult choroidal neovascularization secondary to age-related macular degeneration. This pilot study warrants further research to investigate the efficacy and safety of this form of treatment.

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