June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Clinical Feasibility and Utility of Ultra Wide-Field Indocyanine Green Angiography
Author Affiliations & Notes
  • Thomas Berenberg
    Ophthalmology, Weill Cornell Medical College, New York, NY
  • Swetangi Bhaleeya
    Ophthalmology, Weill Cornell Medical College, New York, NY
  • Matthew Wessel
    Ophthalmology, Weill Cornell Medical College, New York, NY
  • Matthew Witmer
    Ophthalmology, Weill Cornell Medical College, New York, NY
  • Sarju Patel
    Ophthalmology, Weill Cornell Medical College, New York, NY
  • Srinivas Sadda
    Ophthalmology, USC Doheny Eye Institute, Los Angeles, CA
  • Szilard Kiss
    Ophthalmology, Weill Cornell Medical College, New York, NY
  • Footnotes
    Commercial Relationships Thomas Berenberg, None; Swetangi Bhaleeya, None; Matthew Wessel, None; Matthew Witmer, None; Sarju Patel, None; Srinivas Sadda, Regeneron (C), Genentech (C), Allergan (C), Carl Zeiss Meditec (C), Optos (C), Carl Zeiss Meditec (F), Optovue (F), Optos (F); Szilard Kiss, Alcon (F), Alimera (F), Alimera (C), Alimera (R), Allergan (F), Allergan (C), Allergan (R), Genentech (F), Genentech (C), Genentech (R), Regeneron (F), Regeneron (C), Regeneron (R), Optos (F), Optos (C), Optos (R), Eytech (C), Merge/OIS (C), Merge/OIS (I)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4907. doi:
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      Thomas Berenberg, Swetangi Bhaleeya, Matthew Wessel, Matthew Witmer, Sarju Patel, Srinivas Sadda, Szilard Kiss; Clinical Feasibility and Utility of Ultra Wide-Field Indocyanine Green Angiography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4907.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
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.

 
 
Multiple peripheral and posterior pole focal round hypofluorescent areas (yellow arrows) are noted in sarcoid-associated posterior uveitis. A single UWF-ICGA image shows the posterior pole and the peripheral retina beyond the vortex veins (red arrows). The area visualized by the ETDRS 7-fields is shown with the blue circles.
 
Multiple peripheral and posterior pole focal round hypofluorescent areas (yellow arrows) are noted in sarcoid-associated posterior uveitis. A single UWF-ICGA image shows the posterior pole and the peripheral retina beyond the vortex veins (red arrows). The area visualized by the ETDRS 7-fields is shown with the blue circles.
 
Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 452 choroid • 688 retina  
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