Indocyanine green-mediated photothrombosis with and without intravitreal triamcinolone acetonide for subfoveal choroidal neovascularization in age-related macular degeneration: A pilot study

J Fernando Arevalo, Arístides J. Mendoza, Carlos F. Fernández

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the feasibility, safety, and clinical effect of treating patients with subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD) with indocyanine green (ICG)-mediated photothrombosis (IMP) with and without intravitreal triamcinolone acetonide (TA). Methods: Fifteen patients (19 eyes) participated in the study. Nine eyes of seven patients were treated with IMP immediately followed by an intravitreal injection of 4 mg of TA (Group A), and 10 eyes of 8 patients were treated with IMP only (Group B). Patients had a mean follow-up of 6.9 months (range: 3 to 12 months). Patients underwent single or two sessions of IMP. Results: In Group A, visual acuity (VA) showed stability in 6 eyes (66.7%), improvement of VA in 2 eyes (22.2%), and worsening of VA in 1 eye (11.1%). Group B presented VA stability in 9 eyes (90%), and improvement in 1 eye (10%). In total, of the 15 patients (19 eyes) with IMP with or without intravitreal TA, 3 eyes (15.8%) showed improvement, 15 eyes (78.9%) stability, and 1 eye (5.3%) showed worsening of VA. A significant regression of the CNV and diminishing of subretinal fluid was demonstrated with fluorescein angiography and optical coherence tomography in both groups. No patient in Group A required retreament. Four of 10 eyes (40%) in Group B required one retreatment during the study period. Conclusions: ICG-mediated photothrombosis with and without intravitreal TA may provide stability or improvement in visual acuity and fundus findings in subfoveal CNV in AMD. Further evaluation in a multicenter, randomized, placebo-controlled clinical trial with longer follow-up is needed to accurately assess the safety and efficacy of this new treatment modality.

Original languageEnglish (US)
Pages (from-to)719-726
Number of pages8
JournalRetina
Volume25
Issue number6
DOIs
StatePublished - Sep 2005

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Triamcinolone Acetonide
Choroidal Neovascularization
Indocyanine Green
Macular Degeneration
Visual Acuity
Subretinal Fluid
Safety
Intravitreal Injections
Retreatment
Fluorescein Angiography
Optical Coherence Tomography

Keywords

  • AMD
  • Choroidal neovascularization
  • ICG
  • IMP
  • Indocyanine green
  • Intravitreal
  • Photothrombosis
  • Triamcinolone acetonide

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

Cite this

Indocyanine green-mediated photothrombosis with and without intravitreal triamcinolone acetonide for subfoveal choroidal neovascularization in age-related macular degeneration : A pilot study. / Arevalo, J Fernando; Mendoza, Arístides J.; Fernández, Carlos F.

In: Retina, Vol. 25, No. 6, 09.2005, p. 719-726.

Research output: Contribution to journalArticle

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title = "Indocyanine green-mediated photothrombosis with and without intravitreal triamcinolone acetonide for subfoveal choroidal neovascularization in age-related macular degeneration: A pilot study",
abstract = "Purpose: To determine the feasibility, safety, and clinical effect of treating patients with subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD) with indocyanine green (ICG)-mediated photothrombosis (IMP) with and without intravitreal triamcinolone acetonide (TA). Methods: Fifteen patients (19 eyes) participated in the study. Nine eyes of seven patients were treated with IMP immediately followed by an intravitreal injection of 4 mg of TA (Group A), and 10 eyes of 8 patients were treated with IMP only (Group B). Patients had a mean follow-up of 6.9 months (range: 3 to 12 months). Patients underwent single or two sessions of IMP. Results: In Group A, visual acuity (VA) showed stability in 6 eyes (66.7{\%}), improvement of VA in 2 eyes (22.2{\%}), and worsening of VA in 1 eye (11.1{\%}). Group B presented VA stability in 9 eyes (90{\%}), and improvement in 1 eye (10{\%}). In total, of the 15 patients (19 eyes) with IMP with or without intravitreal TA, 3 eyes (15.8{\%}) showed improvement, 15 eyes (78.9{\%}) stability, and 1 eye (5.3{\%}) showed worsening of VA. A significant regression of the CNV and diminishing of subretinal fluid was demonstrated with fluorescein angiography and optical coherence tomography in both groups. No patient in Group A required retreament. Four of 10 eyes (40{\%}) in Group B required one retreatment during the study period. Conclusions: ICG-mediated photothrombosis with and without intravitreal TA may provide stability or improvement in visual acuity and fundus findings in subfoveal CNV in AMD. Further evaluation in a multicenter, randomized, placebo-controlled clinical trial with longer follow-up is needed to accurately assess the safety and efficacy of this new treatment modality.",
keywords = "AMD, Choroidal neovascularization, ICG, IMP, Indocyanine green, Intravitreal, Photothrombosis, Triamcinolone acetonide",
author = "Arevalo, {J Fernando} and Mendoza, {Ar{\'i}stides J.} and Fern{\'a}ndez, {Carlos F.}",
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T1 - Indocyanine green-mediated photothrombosis with and without intravitreal triamcinolone acetonide for subfoveal choroidal neovascularization in age-related macular degeneration

T2 - A pilot study

AU - Arevalo, J Fernando

AU - Mendoza, Arístides J.

AU - Fernández, Carlos F.

PY - 2005/9

Y1 - 2005/9

N2 - Purpose: To determine the feasibility, safety, and clinical effect of treating patients with subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD) with indocyanine green (ICG)-mediated photothrombosis (IMP) with and without intravitreal triamcinolone acetonide (TA). Methods: Fifteen patients (19 eyes) participated in the study. Nine eyes of seven patients were treated with IMP immediately followed by an intravitreal injection of 4 mg of TA (Group A), and 10 eyes of 8 patients were treated with IMP only (Group B). Patients had a mean follow-up of 6.9 months (range: 3 to 12 months). Patients underwent single or two sessions of IMP. Results: In Group A, visual acuity (VA) showed stability in 6 eyes (66.7%), improvement of VA in 2 eyes (22.2%), and worsening of VA in 1 eye (11.1%). Group B presented VA stability in 9 eyes (90%), and improvement in 1 eye (10%). In total, of the 15 patients (19 eyes) with IMP with or without intravitreal TA, 3 eyes (15.8%) showed improvement, 15 eyes (78.9%) stability, and 1 eye (5.3%) showed worsening of VA. A significant regression of the CNV and diminishing of subretinal fluid was demonstrated with fluorescein angiography and optical coherence tomography in both groups. No patient in Group A required retreament. Four of 10 eyes (40%) in Group B required one retreatment during the study period. Conclusions: ICG-mediated photothrombosis with and without intravitreal TA may provide stability or improvement in visual acuity and fundus findings in subfoveal CNV in AMD. Further evaluation in a multicenter, randomized, placebo-controlled clinical trial with longer follow-up is needed to accurately assess the safety and efficacy of this new treatment modality.

AB - Purpose: To determine the feasibility, safety, and clinical effect of treating patients with subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD) with indocyanine green (ICG)-mediated photothrombosis (IMP) with and without intravitreal triamcinolone acetonide (TA). Methods: Fifteen patients (19 eyes) participated in the study. Nine eyes of seven patients were treated with IMP immediately followed by an intravitreal injection of 4 mg of TA (Group A), and 10 eyes of 8 patients were treated with IMP only (Group B). Patients had a mean follow-up of 6.9 months (range: 3 to 12 months). Patients underwent single or two sessions of IMP. Results: In Group A, visual acuity (VA) showed stability in 6 eyes (66.7%), improvement of VA in 2 eyes (22.2%), and worsening of VA in 1 eye (11.1%). Group B presented VA stability in 9 eyes (90%), and improvement in 1 eye (10%). In total, of the 15 patients (19 eyes) with IMP with or without intravitreal TA, 3 eyes (15.8%) showed improvement, 15 eyes (78.9%) stability, and 1 eye (5.3%) showed worsening of VA. A significant regression of the CNV and diminishing of subretinal fluid was demonstrated with fluorescein angiography and optical coherence tomography in both groups. No patient in Group A required retreament. Four of 10 eyes (40%) in Group B required one retreatment during the study period. Conclusions: ICG-mediated photothrombosis with and without intravitreal TA may provide stability or improvement in visual acuity and fundus findings in subfoveal CNV in AMD. Further evaluation in a multicenter, randomized, placebo-controlled clinical trial with longer follow-up is needed to accurately assess the safety and efficacy of this new treatment modality.

KW - AMD

KW - Choroidal neovascularization

KW - ICG

KW - IMP

KW - Indocyanine green

KW - Intravitreal

KW - Photothrombosis

KW - Triamcinolone acetonide

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