Korean J Ophthalmol.  2007 Mar;21(1):55-60. 10.3341/kjo.2007.21.1.55.

Therapeutic Effect of Diode Laser Photodynamic Therapy with ICG Dye in ARMD: A Case Report

• Yoon CK
• Kyoung SE
• Chang MH

• KMID: 1105033
• DOI: http://doi.org/10.3341/kjo.2007.21.1.55

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.

Keyword

Age-related macular degeneration; Choroidal neovascularization; Diode laser; Indocyanine green dye; Photodynamic therapy

MeSH Terms

Treatment Outcome
*Photochemotherapy
Middle Aged
Male
Macular Degeneration/*drug therapy
Lasers/*therapeutic use
Indocyanine Green/*therapeutic use
Humans
Female
Coloring Agents/*therapeutic use
Aged

Figure

• 

  Fig. 1 Color photograph and angiographic findings of CNV due to ARMD. (A) The color photograph shows RPE atrophy and hypertrophy in the macular area of the left eye. (B) Early phase of FAG before treatment shows classic CNV in the subfoveal area, which is smaller than one disc diameter. (C) Late phase of FAG before treatment shows hyperfluorescence from leakage on CNV area. (D) Three months after treatment, no leakage was noted on FAG or hyperfluorescence due to RPE atrophy.

• 

  Fig. 2 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. (B) Early phase of FAG before treatment shows occult CNV in the subfoveal area, which is smaller than one disc diameter. (C) Late phase of FAG before treatment shows hyperfluorescence from leakage in the CNV-involved area. (D) Nine months after treatment, minimal leakage was noted on FAG.

• 

  Fig. 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.

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