Fluorescein and ICG angiograms : still a gold standard

Abstract

Abstract Purpose: To review the role of Fluorescein Angiography and ICG in the management of ARMD Methods: Fundus Fluorescein Angiography (FFA) is the gold standard for classification of Choroidal Neovascular Membranes (CNVMs) in Age Related Macular Degeneration (ARMD). CNVMs may be defined as classic, minimally classic or occult by their filling patterns observed on angiography. The findings of the large TAP and VIP studies are based on angiographically defined CNVMs. FFA in the setting of ARMD is indicated when the patient complains of new metamorphopsia, experiences unexplained blurred vision or there is evidence of subretinal fluid, haemorrhages or hard exudates1,2 .Fluorescein Angiography is an invasive procedure and carries a risk of anaphylaxis and death. There should be on site facilities readily available to manage any potential complications of an FFA.Indocyanine Green Angiography (ICG) is used to evaluate the choroidal circulation and is of particular use in the diagnosis of Idiopathic Polypoidal Choroidal Vasculopathy. Results: With the advent of new therapeutic modalities there is a need for frequent monitoring of the response of the CNVM to treatment. Ocular Coherence Topography complements FFAs and ICG, reducing the number of angiograms required during the quiescent phase of treatment. In spite of this invasive angiography remains the gold standard for diagnosis and treatment Conclusions: References1 Summary benchmarks for Preferred Practice Benchmarks in the Setting of ARMD. www.aao.org2 International Clinical Guidelines for ARMD. www.icoph.org