Indocyanine Green Angiography (ICG)

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Physiology

  • Large molecules (bound to proteins by 98%) that cannot pass out of choroidal vessels
  • Excreted via the liver into the bile
  • Near-infrared range (790-805 nm), less scattering than visible light
    • More suitable for use in cloudy media, hemorrhages, etc.

Indication

  • Choroidal neovascularisation (CNV)
  • Pigment epithelial detachment
  • Polypoidal choroidal vasculopathy (PCV)
  • Central serous chorioretinopathy (CSCR)
  • Intraocular tumors
  • Inflammatory choroidal diseases
    • Serpiginous choroiditis, Acute Posterior Multifocal Placoid Pigment Epitheliopathy (AMPPE), Multiple Evanescent White Dot Syndrome (MEWDS), Birdshot chorioretinopathy, multifocal choroiditis

Side Effects

  • Nausea and vomiting are rare
  • Allergic reaction in case of iodine allergy / shellfish
  • Contraindicated in liver diseases

Sources

  • EyeWiki Indocyanin Green Angiography
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition (2021)
  • Kanski‚Äôs Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)