ICG-guided feeder vessel therapy with the Novadaq OPTTX 2N1 system

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For laser treatment of these vessels the ophthalmologist must confirm the target site and provide laser treatment with conventional slit-lamp delivery viewing systems. The difficulty is in matching the site of the feeder vessel pinpointed on a separate image with that image observed through the slit-lamp laser applicator.

A range of conventional techniques of feeder vessel therapy involve laser photocoagulation.2-4 This may require 'painting' the likely target area with laser radiation. This, however, can result in a larger zone of injury compared to precision targeting of vessels. Also, the treatment of feeder vessels using conventional laser treatments remains a highly skilled procedure where the targeting of laser energy depends on complex interpretation of dynamic ICG images of the retinal microcirculation. The advantage of selective treatment of feeder vessels, however, is that more sensitive structures, such as the neural retina, suffer less trauma. Results quoted by Shiraga5 have reported improved or stabilised visual acuity at 18 months in 70 per cent of cases thus treated.