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April 1994

A Pilot Study of Digital Indocyanine Green Videoangiography for Recurrent Occult Choroidal Neovascularization in Age-Related Macular Degeneration

Author Affiliations

From the LuEsther T. Mertz Retinal Research Laboratory, the Manhattan (NY) Eye, Ear and Throat Hospital. Dr Yannuzzi is a member of the Board of Akorn Inc, Abita Springs, La. None of the authors derives any direct or indirect financial gain or has any proprietary interest in the sale, marketing, or distribution of the products described in this manuscript.

Arch Ophthalmol. 1994;112(4):473-479. doi:10.1001/archopht.1994.01090160049021

Purpose:  Digital indocyanine green videoangiography (ICG-V) was used to study recurrent choroidal neovascularization (CNV) in patients with the clinical and fluorescein angiographic findings indicative of ill-defined, or recurrent occult, CNV (RO-CNV). The use of ICG-V-guided laser caphotocoagulation as an alternative form of treatment was also investigated when a well-delineated area of CNV was imaged with this technique.

Methods:  A consecutive series of 66 patients were studied who presented with exudative age-related macular degeneration and symptoms and clinical manifestations of recurrent CNV in which fluorescein angiography did not reveal classic, or well-defined, neovascularization. Patients were selected for laser treatment based on conventional guidelines if ICG-V imaged a well-delineated area of recurrent CNV.

Results:  Indocyanine green videoangiography showed late staining that was consistent with recurrent CNV in 64 (97%) of these 66 patients with RO-CNV. Twenty-nine (44%) of the 66 were eligible for laser treatment, and 18 (62%) of these 29 patients experienced successful anatomic and visual results, which were defined as resolution of the exudative manifestations and improvement or stabilization (±1 line on a Snellen chart) of vision.

Conclusions:  This pilot study suggests that ICG-V is of value in imaging patients with RO-CNV after laser photocoagulation for CNV secondary to age-related macular degeneration. Laser treatment of RO-CNV with ICG-V guidance may be successful both anatomically and functionally in a promising number of these otherwise untreatable cases. Further studies are necessary to validate these preliminary findings.

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