Identification of feeder vessels in subfoveal choroidal neovascularization

Indocyanine green (ICG) videoangiography was made in 41 eyes of 38 patients with subfoveal choroidal neovascularization (CNV) of age related macular degeneration (AMD) using a scanning laser ophthalmoscope (SLO). Feeder vessels connected with the entire fronds of CNV were identified in 20 eyes, 49%. There were difficulties in the identification due to two dimentional display, blockade by exudates, blood or hyperpigmented epithelial response, and separation of feeder vessels from choroidal arterioles. Photocoagulation of feeder vessels was performed in 15 eyes using 576 and 630 nm dye laser. The feeder vessels could be occluded in 9 eyes, 60%. Clinical success, defined as resolution of exudation and hemorrhage, was attained in 12 of the 15 treated eyes, 80%. Occlusion of feeder vessels was not a prerequisite for clinical success. Only 1 eye lost visual acuity by 3 lines from the baseline level, but visual acuity of 20/40 or better was attained in 3 eyes, 20%. Above findings attest the value of ICG videoangiography in the detection of feeder vessels and in the planning of laser treatment for CNVs of AMD.