parent menu item not found: "75"| Dye-Enhanced Photocoagulation (DEP) for Treatment of Choroidal Neovascularization in Age-related Macular Degeneration: Interim, Preliminary Data from an On-Going Study |
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P. Danzi1, G. Levi1, C. Veronese1, R. Flower2,3, G. Staurenghi4,1; 1Department of Ophthalmology, University of Brescia, Brescia, ITALY , 2Department of Ophthalmology, University of Maryland, Baltimore, MD ,3Department of Ophthalmology, New York University, New York, NY ,4Department of Ophthalmology, University of Milan, Milan, ITALY
PURPOSE:
To compare efficacy of choroidal neovascular membrane (CNV) feeder
vessel treatment (FVT) preformed by application of 810 nm laser energy
during indocyanine green (ICG) dye transit through the feeder vessels
(i.e., DEP) to application of the laser energy alone.
A fundus camera was modified for ICG angiography by replacing its xenon
flash lamp with an 810 nm wavelength diode laser. Live ICG images were
acquired by a CCD video camera and displayed on a LCD monitor located
above the patient’s eye. The output fiber optic of an 810 nm laser
photocoagulator was mounted on a joystick-controlled micromanipulator
in the fundus camera’s optical system for positioning the
photocoagulator laser beam on the fundus while viewing live ICG video
images of the choroidal vasculature. The device makes possible precise
delivery of photocoagulation energy to CNV FVs upon arrival of a
secondarily-injected, high-concentration ICG dye bolus in a targeted
FV. Patients are randomized to ICG-DEP FVT or FVT alone.
24 patients randomized to date (12 FVT / 12 ICG-DEP FVT). Data at 6
months are consistent with published outcomes for overall FVT vessel
closure, but there were differences related to the FVT method applied:
83% closed in the ICG-DEP FVT arm, 64% closed in the FVT only arm. The
number of laser burns to achieve the closure with DEP FVT were less
than FVT (3 to 9 vs. 100 to 300).
Preliminary data analysis suggests that feeder vessels are identifiable
and treatable during the dye transit. ICG-DEP appears to facilitate FVT
by reducing the number of burns necessary for vessel closure and makes
the treatment of larger diameter new vessels possible. |