Purpose
Indocyanine green angiography (ICGA) remains an important diagnostic tool in the evaluation of posterior inflammatory disorders and a useful adjuvant imaging modality in diseases such as age-related macular degeneration (AMD) and central serous choroidopathy (CSR). Although peripheral retinal evaluation with ultra wide-field (UWF) fundus photography and fluorescein angiography (FA) is becoming increasingly important in the diagnosis, monitoring and treatment of numerous retinal disorders, the clinical utility of UWF-ICGA has not been previously described. The purpose of this study is to determine the feasibility of acquiring UWF-ICGA images and to evaluate the potential clinical usefulness of peripheral ICGA in a variety of retinal conditions.
Methods
Patients underwent UWF-ICGA imaging with an Optos P200Tx UWF device modified with an appropriate laser light source and filters to allow for ICGA imaging of up to 200 degrees of the retina in a single image. Thirty eyes of 15 patients were included in this prospective study. All angiograms performed were captured with appropriate resolution and were included in the analysis.
Results
Retinal pathologies included posterior uveitis (7), CSR (4), AMD (2), macular dystrophy (1), and retinal degeneration (1). Both peripheral and central choroidal and retinal vasculature was well visualized. Of the thirty UWF-ICG angiograms evaluated, 12 revealed pathology located primarily in the posterior pole, 2 showed predominantly peripheral pathology, and 16 eyes exhibited both central and peripheral pathology.
Conclusions
UWF-ICGA is clinically practical and provides imaging of the peripheral and posterior pole choroidal vasculature comparable to the field of view seen on UWF-FA (approximately 200 degrees in a single shot). Patients with a variety of retinal disorders exhibit abnormalities in the peripheral retina that may otherwise be missed on conventional ICGA imaging. The clinical significance of these peripheral findings will undoubtedly require larger prospective studies.
Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) •
452 choroid •
688 retina