What is focal choroid?
Focal choroid laser treatment is a procedure used to treat extrafoveal CNV which is present in conditions such as neovascular age-related macular degeneration (wet AMD), myopic degeneration, and other more rare conditions. These conditions lead to damaged vessel(s) that leak leading to the accumulation of fluid buildup in the macula. The macula is the central area of the retina which holds the highest concentration of photoreceptor cells that aid in providing us with the majority for central vision and color detail. If left untreated, the fluid buildup results in macular swelling and eventual damage to the photoreceptors leading to progressive permanent vision loss. Focal choroidal laser therapy uses a finite amount/power/distribution of laser spots which can seal the CNV creating a microscopic scar. Once leakage stops or reduces, the remaining fluid will then be reabsorbed into the eye leading to stabilization and/or improvement of visual acuity. It can take weeks to months, and often repeat treatments months apart, before desired results are achieved. This laser therapy is only done for extrafoveal CNV (i.e. CNV that does not involve the central macula); otherwise, a scotoma or blind spot can occur.
What to expect?
Before the procedure begins, the ophthalmologist needs to determine which area is leaking near the macula. It is common for the doctor to conduct fluorescein angiography (FA) and/or Indocyanine green (ICG), which reveal the specific location of the CNV and to what extent it is leaking. Your eye will be dilated to ensure that the view to the retina is optimal for treatment. Following confirmation that the patient is a candidate for focal laser, the patient’s chair will be adjusted into a comfortable position so the patient can place their chin on the slit lamp. Our laser technician will then place a topical anesthetic on the surface of the eye. Next, the doctor will place a contact lens with sterile gel onto the surface of the. The procedure itself takes 10-60 seconds. The patient will experience haziness and colored vision for up to 10 minutes following the procedure, after which the vision will return to pre-treatment level although dilation will last approximately 4 hours. There is no patch or post-procedure care such as eye drops required following focal laser. There is no pain with this procedure.