INDOCYANINE GREEN-GUIDED LASER PHOTOCOAGULATION OF FOCAL SPOTS AT THEEDGE OF PLAQUES OF CHOROIDAL NEOVASCULARIZATION

Objective: To determine whether indocyanine green-guided laser photoco agulation of focal spots at the edge of plaques of neovascularization is beneficial for patients with untreatable occult choroidal neovascul arization by fluorescein imaging. Patients: A pilot series of 23 eyes were identified that had untreatable occult choroidal neovascularizati on secondary to age-related macular degeneration with focal spots at t he edge of a plaque of neovascularization on the indocyanine green stu dy. After informed consent was obtained, indocyanine green-guided lase r photocoagulation was applied solely to the focal spot at the edge of the plaque. Results: Anatomical success with resolution of the exudat ive findings was noted in 15 (79%) of 19 eyes at 6 months, 13 (68%) of 19 eyes at 12 months, and six (37.5%) of 16 eyes at 24 months. The me dian follow-up period was 18 months (range, 3 to 44 months). Visual ac uity was stabilized or improved in nine (69%) of 13 successfully treat ed eyes at 1 year. Of the successfully treated cases at 1 year, nine ( 69%) of 13 had a final visual acuity of 20/100 or better. Conclusions: Our preliminary study of indocyanine green-guided laser photocoagulat ion of focal spots at the edge of plaques of neovascularization sugges ts that this technique may improve the visual prognosis of these patie nts with presently untreatable disease. A prospective, randomized, con trolled clinical trial is warranted to evaluate this treatment approac h.