Indocyanine Green Angiographic Features in Multifocal Chorioretinitis Associated With West Nile Virus Infection

Abstract

Abstract: : Purpose:To describe indocyanine green (ICG) angiographic features in multifocal chorioretinitis associated with West Nile virus (WNV) infection. Methods: This study included 9 consecutive patients (18 eyes) with serologically proven WNV infection. All patients underwent a complete ophthalmic evaluation, including ophthalmoscopy, fundus photography, fluorescein angiography, and ICG angiography. Results: Fundus examination and fluoresein angiography showed bilateral (n=7) or unilateral (n=2) multifocal chorioretinitis. Chorioretinal lesions, variable in number and size, were partially atrophic and partially pigmented with central hypofluorescence and peripheral hyperfluorescence. ICG angiography showed in all patients bilateral well–delineated hypofluorescent choroidal lesions, which were more numerous than those appreciated on fluorescein angiography or clinically. In addition, two patients had unilateral focal retinal arterial ICG hyperfluorescence, without evidence of corresponding abnormalities on clinical examination or fluorescein angiography. Conclusions: ICG angiography is useful in assessing and quantifying the extent of choroidal involvement in patients with WNV infection. Additional studies are required to characterize further ICG features of WNV–associated chorioretinitis at different disease stages.

Keywords: chorioretinitis • imaging/image analysis: clinical • inflammation