Indocyanine Green/therapeutic use* ; Photochemotherapy ; Combined Modality Therapy ; Anti-Infective Agents

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

PURPOSE: Primary vascular dysregulation (PVD) is a condition in which the response to cold temperature or external stimuli is abnormal. We investigated whether triflusal use results in amelioration of PVD symptoms and improvement of several related parameters compared with aspirin. MATERIALS AND METHODS: Eighty-eight PVD patients (54% female, 56+/-8 years) were randomly selected to receive either triflusal (300 mg, b.i.d.) or aspirin (150 mg, b.i.d.) for a period of 6 weeks followed by crossover. PVD was defined as both red-blood-cell standstill in video-assisted microscopic capillaroscopy during cold stimulation using carbon dioxide gas and a score of more than 7 points in a validated questionnaire. Efficacy of treatment was assessed by 1) cold intolerance symptom severity (CISS) score, 2) finger Doppler indices, and 3) indocyanine green perfusion imaging. RESULTS: The use of triflusal resulted in a greater improvement in CISS score (44.5+/-18.4 vs. 51.9+/-16.2; p<0.001) and in mean radial peak systolic velocity (69.8+/-17.2 vs. 66.1+/-16.4; p=0.011) compared to aspirin. Furthermore, significant differences were also observed in perfusion rates on indocyanine green perfusion imaging between triflusal and aspirin (45.6+/-25.8 vs. 51.6+/-26.9; p=0.020). CONCLUSION: Triflusal was more effective and demonstrated a more consistent impact on the improvement of symptoms and blood flow in patients with PVD than aspirin.
Adult ; Aspirin/*therapeutic use ; Cardiovascular Diseases/*drug therapy ; Cross-Over Studies ; Double-Blind Method ; Female ; Humans ; Indocyanine Green ; Male ; Middle Aged ; Perfusion Imaging ; Platelet Aggregation Inhibitors/*therapeutic use ; Recurrence ; Salicylates/*therapeutic use ; Treatment Outcome

OBJECTIVE: Indocyanine green with near-infrared fluorescence imaging (NIR-ICG) is a new tracer modality in the limelight used for lymphatic mapping. The advantage of this method is to provide real-time image during surgery. To use ICG for image guided lymph node dissection, a surgeon needs to know initial appearing time and duration. METHODS: A 52-year-old woman undertook surgery diagnosed with endometrial cancer. She had no past medical history and her body mass index was 25.3 kg/m2. Preoperative magnetic resonance imaging examination revealed 2.7 cm sized cancerous mass in the endometrial cavity with superficial myometrial invasion without lymph node enlargement. Four mL (1.25 mg/mL) of ICG solution was prepared for injection. For each site, 1 mL of solution was injected superficially, 2-3 mm into the cervical submucosa and another 1 mL was injected deep, 1-2 cm into the stroma of the cervix. We recorded video with 30° 10 mm scope equipped with a specific lens and light source emitting both visible and NIR light (KARL STORZ GmbH & Co. KG, Tuttlingen, Germany). RESULTS: Pelvic lymph node was visualized from around 5 minutes. ICG was dispersed into organs after hysterectomy (53 minutes after ICG injection), yet we could clearly identify sentinel lymph node (SLN). Pathology revealed endometriod adenocarcinoma grade I, myometrial invasion with less than half of myometrium and no lymph node metastasis. CONCLUSION: Cervical injection of ICG provides good visualization of SLN from 5 minutes to over an hour. Our film gives an idea about time management to make a plan for surgery and not to miss SNLs.
Adenocarcinoma/diagnostic imaging/*pathology ; Coloring Agents/*therapeutic use ; Endometrial Neoplasms/diagnostic imaging/*pathology ; Female ; Humans ; Indocyanine Green/*therapeutic use ; Lymphatic Metastasis/diagnostic imaging ; Middle Aged ; Optical Imaging/methods ; Sentinel Lymph Node/*diagnostic imaging ; Time-Lapse Imaging/methods

Sixteen cases of malignant soft tissue sarcoma (STS; 10 canines and six felines) were treated with a novel triple therapy that combined photodynamic therapy, hyperthermia using indocyanine green with a broadband light source, and local chemotherapy after surgical tumor resection. This triple therapy was called photodynamic hyperthermal chemotherapy (PHCT). In all cases, the surgical margin was insufficient. In one feline case, PHCT was performed without surgical resection. PHCT was performed over an interval of 1 to 2 weeks and was repeated three to 21 times. No severe side effects, including severe skin burns, necrosis, or skin suture rupture, were observed in any of the animals. No disease recurrence was observed in seven out of 10 (70.0%) dogs and three out of six (50.0%) cats over the follow-up periods ranging from 238 to 1901 days. These results suggest that PHCT decreases the risk of STS recurrence. PHCT should therefore be considered an adjuvant therapy for treating companion animals with STS in veterinary medicine.
Animals ; Antineoplastic Agents/*therapeutic use ; Cat Diseases/drug therapy/surgery/*therapy ; Cats ; Combined Modality Therapy/veterinary ; Dog Diseases/drug therapy/surgery/*therapy ; Dogs ; Hyperthermia, Induced/veterinary ; Indocyanine Green/*therapeutic use ; Photochemotherapy/veterinary ; Photosensitizing Agents/*therapeutic use ; Sarcoma/drug therapy/surgery/therapy/*veterinary

Cat-scratch disease is a self-limited infection characterized by subacute regional lymphadenitis, which is usually preceded by a history of being scratched by a cat infected with the Bartonella species. Neuroretinitis, retinochoroiditis, isolated papillitis and peripapillary angiomatosis are features of posterior segment involvement. However, vision loss is very rare. We report a patient with cat-scratch disease associated with unilateral neuroretinitis and peripapillary serous retinal detachment, and discuss its fluorescein and indocyanine green angiographic features.
Adolescent ; Animal ; Anti-Infective Agents/therapeutic use ; Case Report ; Cat-Scratch Disease/*complications/diagnosis/therapy ; Cats ; Fluorescein Angiography ; Human ; Indocyanine Green/diagnostic use ; Lymph Nodes/pathology ; Male ; Retinal Detachment/diagnosis/*etiology/therapy ; Retinitis/diagnosis/*etiology/therapy ; Treatment Outcome ; Trimethoprim-Sulfamethoxazole Combination/therapeutic use ; Visual Acuity

PURPOSE: To evaluate the efficacy and safety of intravitreal bevacizumab for polypoidal choroidal vasculopathy (PCV). METHODS: In this retrospective interventional pilot study, 12 eyes of 11 patients with active PCV were treated with intravitreal bevacizumab (1.25 mg) alone or in combination with photodynamic therapy (PDT) depending on the informed patient's choice. Intravitreal bevacizumab was repeated at 6-week intervals until the regression of active lesion was detected on fluorescein angiography (FA) which was done on a regular basis, Indocyanine green angiography (ICGA) and optical coherence tomography (OCT) analyses. RESULTS: Intravitreal bevacizumab was given alone in 8 eyes (Group 1) and in combination with PDT in 4 eyes (Group 2). Mean follow-up duration was 17 weeks in group 1 and 15 weeks in group 2 after bevacizumab treatment. The mean number of bevacizumab injections was 2.2 in group 1 and 2.5 in group 2. Mean BCVA improved from 20/63 to 20/40 in group 1 and 20/63 to 20/32 in group 2. Of all eyes, the BCVA improved by > or =2 lines in seven (58%) eyes and resolution of fluid and hemorrhages in clinical examination, an absence of leakage on repeat FAs, or resolved pigment epithelial detachment (PED) and/or subretinal fluid (SRF) on OCT exam was confirmed in 10 (83%) eyes. Partial or complete regression of the polypoidal vessels and interconnecting vessels was reported for most cases at the last follow-up. No significant ocular or systemic side effects were observed in both groups. CONCLUSIONS: Short-term results indicate that intravitreal bevacizumab (1.25 mg) alone or in combination with PDT is well tolerated and associated with improvement in BCVA and reduced angiographic leakage in most patients. Further evaluation of intravitreal bevacizumab therapy for the treatment of PCV is warranted.
Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/adverse effects/*therapeutic use ; Antibodies, Monoclonal/adverse effects/*therapeutic use ; Choroid/*blood supply/pathology ; Coloring Agents/diagnostic use ; Combined Modality Therapy ; Female ; Fluorescein Angiography ; Humans ; Indocyanine Green/diagnostic use ; Injections ; Male ; Middle Aged ; Peripheral Vascular Diseases/diagnosis/*drug therapy/physiopathology ; *Photochemotherapy ; Pilot Projects ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology ; Vitreous Body