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Therapeutic effect of diode laser photodynamic therapy with ICG dye in ARMD: a case report.

Yoon CK, Kyoung SE, Chang MH - Korean J Ophthalmol (2007)

Bottom Line: Compared to the widely used verteporfin, ICG is more stable and is more cost effective.The authors therefore came to a conclusion that ICG can be very useful in the treatment of CNV.However, further studies are necessary.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea.

ABSTRACT

Purpose: To evaluate the diode laser photodynamic therapy efficacy on choroidal neovascularization (CNV) in the treatment of three patients with age-related macular degeneration (ARMD).

Methods: The authors selected three patients with ARMD whose vision has decreased due to CNV, and applied diode laser treatment after injecting an indocyanine green (ICG) solution. The patients were followed for at least three months after treatment, and examinations included evaluating vision changes and possible leakage on fluorescein angiography (FAG).

Results: The final vision of two patients improved by more than one line on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart after at least three months of follow-up. However, the final vision of the third patient decreased by one line on ETDRS chart. FAG was done in all patients, and in two of the patients, there was no evidence of leakage at the laser-applied site. In the other patient, there was evidence of minimal leakage, with the area of leakage decreasing by more than fifty percent. Side effects of ICG were not found during or after the photodynamic therapy sessions.

Conclusions: The photodynamic usage of ICG treatment of CNV in patients with ARMD, was effective in preventing or improving the visual outcome. Compared to the widely used verteporfin, ICG is more stable and is more cost effective. The authors therefore came to a conclusion that ICG can be very useful in the treatment of CNV. However, further studies are necessary.

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Related in: MedlinePlus

Color photograph and angiographic findings of CNV due to ARMD. (A) The color photograph shows RPE atrophy and hypertrophy, soft drusen, and exdudate in the macular area of the right eye. A small amount of hemorrhage is also observed around the macular area. (B) Early phase of FAG before treatment shows a hyperfluorescent lesion on the nasal side of the macula due to RPE atrophy. (C) Late phase of FAG before treatment shows hyperfluorescence from leakage of occult CNV in the subfoveal area, which is smaller than one disc diameter. (D) Nine months after treatment, no leakage was noted on FAG.
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Figure 3: Color photograph and angiographic findings of CNV due to ARMD. (A) The color photograph shows RPE atrophy and hypertrophy, soft drusen, and exdudate in the macular area of the right eye. A small amount of hemorrhage is also observed around the macular area. (B) Early phase of FAG before treatment shows a hyperfluorescent lesion on the nasal side of the macula due to RPE atrophy. (C) Late phase of FAG before treatment shows hyperfluorescence from leakage of occult CNV in the subfoveal area, which is smaller than one disc diameter. (D) Nine months after treatment, no leakage was noted on FAG.

Mentions: Dilated retinal examination showed atrophy as well as hypertrophy of the retinal epithelial layer in his right macular region. There was no evidence of a soft drusen or small areas of retinal hemorrhage in the macula. FAG revealed a hyperfluorescent area located in the nasal macular region due to atrophy of the RPE layer, and a subfoveal occult CNV the size of an optic disc showed increase in the area of hyperfluorescence towards the end of the FAG due to leakage (Fig. 3A-C).


Therapeutic effect of diode laser photodynamic therapy with ICG dye in ARMD: a case report.

Yoon CK, Kyoung SE, Chang MH - Korean J Ophthalmol (2007)

Color photograph and angiographic findings of CNV due to ARMD. (A) The color photograph shows RPE atrophy and hypertrophy, soft drusen, and exdudate in the macular area of the right eye. A small amount of hemorrhage is also observed around the macular area. (B) Early phase of FAG before treatment shows a hyperfluorescent lesion on the nasal side of the macula due to RPE atrophy. (C) Late phase of FAG before treatment shows hyperfluorescence from leakage of occult CNV in the subfoveal area, which is smaller than one disc diameter. (D) Nine months after treatment, no leakage was noted on FAG.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2629683&req=5

Figure 3: Color photograph and angiographic findings of CNV due to ARMD. (A) The color photograph shows RPE atrophy and hypertrophy, soft drusen, and exdudate in the macular area of the right eye. A small amount of hemorrhage is also observed around the macular area. (B) Early phase of FAG before treatment shows a hyperfluorescent lesion on the nasal side of the macula due to RPE atrophy. (C) Late phase of FAG before treatment shows hyperfluorescence from leakage of occult CNV in the subfoveal area, which is smaller than one disc diameter. (D) Nine months after treatment, no leakage was noted on FAG.
Mentions: Dilated retinal examination showed atrophy as well as hypertrophy of the retinal epithelial layer in his right macular region. There was no evidence of a soft drusen or small areas of retinal hemorrhage in the macula. FAG revealed a hyperfluorescent area located in the nasal macular region due to atrophy of the RPE layer, and a subfoveal occult CNV the size of an optic disc showed increase in the area of hyperfluorescence towards the end of the FAG due to leakage (Fig. 3A-C).

Bottom Line: Compared to the widely used verteporfin, ICG is more stable and is more cost effective.The authors therefore came to a conclusion that ICG can be very useful in the treatment of CNV.However, further studies are necessary.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea.

ABSTRACT

Purpose: To evaluate the diode laser photodynamic therapy efficacy on choroidal neovascularization (CNV) in the treatment of three patients with age-related macular degeneration (ARMD).

Methods: The authors selected three patients with ARMD whose vision has decreased due to CNV, and applied diode laser treatment after injecting an indocyanine green (ICG) solution. The patients were followed for at least three months after treatment, and examinations included evaluating vision changes and possible leakage on fluorescein angiography (FAG).

Results: The final vision of two patients improved by more than one line on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart after at least three months of follow-up. However, the final vision of the third patient decreased by one line on ETDRS chart. FAG was done in all patients, and in two of the patients, there was no evidence of leakage at the laser-applied site. In the other patient, there was evidence of minimal leakage, with the area of leakage decreasing by more than fifty percent. Side effects of ICG were not found during or after the photodynamic therapy sessions.

Conclusions: The photodynamic usage of ICG treatment of CNV in patients with ARMD, was effective in preventing or improving the visual outcome. Compared to the widely used verteporfin, ICG is more stable and is more cost effective. The authors therefore came to a conclusion that ICG can be very useful in the treatment of CNV. However, further studies are necessary.

Show MeSH
Related in: MedlinePlus