Anterior segment indocyanine green angiography in anterior scleritis and episcleritis

Abstract

Objective To evaluate the pattern of anterior segment indocyanine green (ICG) angiography in episcleritis and scleritis. Design Prospective comparative (paired-eye) observational case series. Participants Twenty subjects presenting clinical diseases compatible with episcleritis or scleritis. Methods Anterior segment ICG angiography was performed according to a standard protocol in subjects presenting either episcleritis or scleritis. Photographs of the anterior segment were taken in the early phase (up to 3 minutes after dye injection), intermediate phase (10–12 minutes) and late phase (30–45 minutes). The inflamed zones were compared with the same regions of the controlateral eye. The amount of protein ICG exudation was scored by a masked observer as follows: zero for no exudation, one for slight exudation, two for moderate exudation, and three for severe exudation. Main outcome measures Evaluation of dye leakage, which reflects protein exudation, with anterior segment ICG angiography in episcleritis and scleritis. Results Twenty subjects with a mean age of 43 ± 15 years (7 male, 13 female) were enrolled in the study. Thirteen subjects had anterior scleritis (7 nodular, 5 diffuse, and 1 scleromalacia perforans), and 7 subjects had episcleritis. Only 1 out of 7 subjects with episcleritis showed a slight ICG leakage (a score of one), whereas all subjects with scleritis had ICG leakage scores of one or more ( P = 0.0005, Fisher exact test). Conclusions ICG angiography of the anterior segment of the eye is a good clinical test to differentiate episcleritis from scleritis.