Results Of Indocyanine Green Angiography Research Articles

A diagnostic assessment of angioarchitectonics of choroidal melanoma

Purpose: to study angioarchitectonics of choroidal melanoma with varied biometric characteristics by comparing the results of indocyanine green angiography (IAG) and OCT angiography (OCTA).Material and methods. Angiography with indocyanine green and OCT angiography was performed in 45 choroidal melanoma patients (45 eyes, 20 men, 25 women, mean age 57.36 ± 15.11 years) to see the features of angioarchitectonics for various tumor elevations: up to 3 mm (small choroidal melanomas) and within the 3.1– 5.0 mm range (medium choroidal melanomas) and assess the informative value of the techniques.Results. We established a high diagnostic value of angiography with indocyanine green and OCT angiography in the diagnosis of vasculature of choroidal melanoma (89% and 71 %, respectively), an acceptable significance in small choroidal melanomas, and a higher informative value of angiography with indocyanine green in medium choroidal melanomas. The vasculature of small choroidal melanomas is characterized by type 1 angioarchitectonics predominance (59 %), while that of medium-sized melanomas corresponds to type 2 angioarchitectonics (81 %). The pattern match in angiography with indocyanine green and OCT angiography took place in 93.8 % of patients. The average depth of vessel identification during OCT angiography was determined to stay within the range of 186 μm for choroidal melanomas of up to 1.9 mm high, 220 μm for melanomas between 2 and 3 mm high, and 255 μm for melanomas higher than 3 mm.Conclusions. The use of contrast and non-contrast angiography in assessing the vasculature of choroidal melanoma is highly informative and useful for the assessment of the type of angioarchitectonics. The use of OCT angiography is more informative for tumors with an elevation of up to 3 mm. In order to increase the accuracy and effectiveness of OCTA, the identification of newly formed vessels should be carried out with regard to the parameters established.

A Multiple Evanescent White Dot Syndrome–like Reaction to Concurrent Retinal Insults

To describe a clinical picture resembling classic multiple evanescent white dot syndrome (MEWDS) potentially triggered by previous or concurrent, apparently unrelated, ocular events and to provide a literature review of similar presentations. Retrospective chart series and literature review. Consecutive patients diagnosed with MEWDS at the Feinberg School of Medicine, Northwestern University, Chicago, Illinois, and the IRCCS San Raffaele Scientific Institute, Milan, Italy, between July 2019 and June2020. Charts of patients were reviewed. Ophthalmic history, best-corrected visual acuity, spectral-domain OCT results, OCT angiography results, fundus autofluorescence results, ultra-widefield fluorescein angiography results, and indocyanine green angiography results were collected. A PubMed-based search was carried out for similar presentations using the terms MEWDS and white spot syndromes. An ocular history positive for previous or concurrent ocular events in patients with MEWDS was sought in our cohort and the existing literature. Five eyes of 4 patients (2 females; age range, 16-81 years) were included. The first eye had a history of bilateral Best vitelliform dystrophy and unilateral choroidal neovascularization. The second eye had angioid streaks complicated by choroidal neovascularization and underwent prior thermal laser photocoagulation. The third eye had a history of high myopia and a scleral buckle procedure for retinal detachment. The fourth patient had bilateral idiopathic retinochoroiditis. We identified 16 case reports from 5 previous publications that support a MEWDS-like reaction to previous ocular insults. We suggest a MEWDS-like reaction may be elicited by ocular events in a subset of susceptible patients. We hypothesize that damage to the outer retina may play a role in triggering the local inflammatory response.

Indocyanine green angiography in the diagnostics of choroidal tumors

To study the use of ultrasound color Doppler imaging and indocyanine green (ICG) angiography for identification of malignant vasculature of choroidal tumors. The study included 46 patients (46 eyes) with tumors of the choroid: 19 men and 26 women aged 22 to 89 years, average age 53.2±17.1 years. All patients underwent indocyanine green angiography and Doppler ultrasound imaging. At the time of examination, thickness of the tumors ranged from 1.1 mm to 3.0 mm, and the base diameter from 4.0 mm to 13.0 mm. Choroidal melanoma was diagnosed in 27 patients, choroidal nevus in 10, choroidal hemangioma in 5, and choroidal metastasis in 4 patients. The results of indocyanine green angiography demonstrate that the pathological malignant vasculature was determined: nevi was diagnosed in 7 out of 10 patients, choroidal melanoma in 16 out of 27, metastasis in 2 out of 4, and hemangioma in none of the 5 patients. Pathological malignant vasculature was determined in most patients with choroidal melanoma (77.8%), in all patients with choroidal hemangioma and in 3 patients with choroidal metastases. Ultrasound imaging revealed malignant vasculature in 15 of 27 (56%) patients with choroidal melanoma, it could be identified in all patients with hemangioma in 2 patients and with choroidal metastases, and in none patients with choroidal nevi. Indocyanine green angiography helps verify malignant vasculature in 77.8% of patients with small and medium sized choroidal melanomas. Angioarchitecture of choroidal tumors visualized with indocyanine green angiography is characterized by variability of patterns, which should be taken into account in the differential diagnosis of various pathological diseases.

Long-term follow-up of half-fluence photodynamic therapy in acute central serous chorioretinopathy

To evaluate the long-term results of indocyanine green angiography(ICGA)-guided verteporfin (Visudyne®, Novartis, Basel, Switzerland) photodynamic therapy (PDT) with half-fluence rate in the treatment of acute symptomatic central serous chorioretinopathy (CSC). A retrospective review was performed of 12 patients with acute symptomatic CSC verified by spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA), treated with ICGA-guided verteporfin (6 mg/m2)-PDT with half-fluence rate (25 J/cm2). The vision-related quality of life (VR QOL) 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) was completed by all patients and 82 controls. Best corrected visual acuity (BCVA) at baseline was 77.5 (±10; n = 12) according to the Early Treatment Diabetic Retinopathy Study (EDTRS) letter score and changed to 89 letters (±9.9; p = 0.0003) at long-term follow-up (83.8 ± 4.8 months after PDT). Baseline contrast sensitivity (CS) was 29.5 ± 4.5 Pelli–Robson letters and increased to 34.5 ± 4.5 letters at long term (p < 0.0006). Baseline central foveal thickness (CFT) was 419 μm and decreased to 242 µm at long term (p < 0.0001). The long-term vision-related quality of life of patients was similar to that of controls. ICGA-guided half-fluence PDT with verteporfin results in excellent long-term visual improvement in BCVA and CS, a significant reduction of CFT, and high levels of VR QOL.

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy.

PurposeTo evaluate the results of indocyanine green angiography (ICGA)-guided verteporfin photodynamic therapy (PDT) with half-fluence rate combined with intravitreal application of anti-VEGF in treating choroidal neovascularization (CNV) in chronic central serous chorioretinopathy (CSCR).Patients and methodsIn this retrospective cohort study 17 consecutive patients with secondary CNV due to chronic CSCR had their diagnosis verified with fluorescein angiography (FA) and ICGA at baseline. All eyes received either intravitreal ranibizumab (IVR) or bevacizumab (IVB). On the consecutive day following the initial IVR/IVB treatment, ICGA-guided verteporfin (6 mg/m(2)) PDT with half-fluence rate (25 J/cm(2)) was performed on every patient. IVR or IVB was rescheduled on a pro re nata regimen. Main outcome measures were changes in visual acuity (VA) according to the ETDRS letter score and changes in the central foveal thickness (CFT).ResultsBest-corrected VA at baseline was 65.6 letters (±6.7; n=17) according to the ETDRS letter score. At 12 months, mean ETDRS letter score improved to 71.2 letters (P=0.34). CFT was 309 μm and decreased to 216 μm at month 12 control (P=0.0004). Nine eyes (52.9%) received additional treatment with IVR/IVB due to recurrence of subretinal fluid, with an overall mean number of IVR/IVB treatment of 1.8±3.6 per patient with no systemic side effects during 12 months' follow-up.ConclusionsIVR or IVB combined with ICGA-guided half-fluence PDT with verteporfin is effective in treating CNV in chronic CSCR, with choroidal hyperpermeability in ICGA, resulting in stable vision and significant reduction of CFT.

Small retinal haemorrhages accompanied by macular soft drusen: prevalence, and funduscopic and angiographic characteristics

PurposeTo investigate the prevalence and clinical significance of small retinal haemorrhages accompanied by macular soft drusen in exudative age-related macular degeneration (AMD).MethodsThis observational case series included patients who had first...

HALF-FLUENCE PHOTODYNAMIC THERAPY IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY

To evaluate the results of indocyanine green angiography (ICGA)-guided verteporfin (Visudyne®; Novartis Pharma, Switzerland) photodynamic therapy (PDT) with half-fluence rate in the treatment of chronic central serous chorioretinopathy. A retrospective review was conducted of 20 eyes of 19 consecutive patients with subfoveal fluid cause by chronic central serous chorioretinopathy with choroidal hyperpermeability on ICGA and symptoms of at least 6 months. ICGA-guided verteporfin (6 mg/m) PDT with half-fluence rate (25 J/cm) was performed. ICGA findings were classified as intense, intermediate, or minimal hyperfluorescence depending on the degree of choroidal hyperpermeability. The resolution of the subretinal fluid and recurrence rates were assessed in relation to the different degrees of choroidal hyperfluorescence. Best-corrected visual acuity at baseline was 40 letters (±13; n = 20) according to the Early Treatment Diabetic Retinopathy Study chart. At 12 months after PDT, the mean best-corrected visual acuity improved to 44 letters (P < 0.01). Pretreatment central foveal thickness 325 μm and decreased by a mean of 103 μm at Month 12 control (P < 0.05). At Month 1 after PDT, subretinal fluid in spectral-domain optical coherence tomography was completely resolved in 100% of eyes regardless to their degree of choroidal hyperfluorescence. Two eyes of the intense hyperfluorescence group and 1 eye of the intermediate hyperfluorescence group developed recurrence of symptoms over 12 months and received another PDT with half-fluence rate within the 12-month control period. Treatment effect was not depending on the degree of choroidal hyperpermeability at baseline. No systemic side effects were observed during the 12-month follow-up. ICGA-guided half-fluence PDT with verteporfin is effective in treating chronic symptomatic central serous chorioretinopathy with choroidal hyperpermeability in ICGA, resulting in both visual improvement and reduction of central foveal thickness.

Clinical Features, Treatment Methods, and Evolution of Birdshot Chorioretinopathy in 5 Different Families

To report familial cases of birdshot chorioretinopathy (BSCR). Retrospective, observational case series. Five families with 2 members in each (10 patients) with BSCR were included in this case series from a cohort of 225 patients followed up for BSCR. A review of medical and angiographic records of familial cases of BSCR was performed. We described and compared in each family the histocompatibility leukocyte antigen (HLA) typing, age at onset, ethnic group, clinical features, fluorescein and indocyanine green angiography results, evolution of disease, and treatment used with efficiency. HLA-A29 and HLA-B44 results were positive in 100% of patients tested. Mean age at onset was 46.5 years. All patients were White. Corticosteroids were required in 7 patients, and 3 patients had no treatment because of mild or moderate lesions. Cyclosporine A was administered in 2 patients from the same family. Period of follow-up ranged from 1 to 32 years (median, 7 years). Familial forms of BSCR remain rare and do not justify systematic examination in relatives of patients with BSCR.

Indocyanine Green Angiography Abnormality of the Periphery in Vitelliform Macular Dystrophy

To report the peripheral abnormalities seen only with indocyanine green angiography in patients with vitelliform macular dystrophy (Best disease, caused by a mutation in the bestrophin gene). Observational case report series. Eight eyes of four patients, two with only a central macular lesion and two with multifocal lesions, were studied. Results of indocyanine green angiography were compared with findings from ophthalmoscopy and fluorescein angiography. Throughout the fundus periphery, indocyanine green angiography demonstrated a number of hyperfluorescent spots in all eight eyes. The spots were observed in the midperiphery and the periphery in areas with no abnormality visible by ophthalmoscopy or fluorescein angiography. Although Best disease generally causes lesions visible in the posterior pole, the extensive distribution of the hyperfluorescent spots is consistent with the wide-ranging abnormalities of the retinal pigment epithelium, Bruch membrane, and the choroid as seen histopathologically.

Indocyanine green angiography in systemic lupus erythematosus-associated uveitis

Purpose: To report indocyanine green (ICG) angiography findings in a patient with systemic lupus erythematosus-associated uveitis. Methods: Review of the patient’s clinical records. Results: ICG angiography revealed dilatation of individual choroidal vessels in the early phase. Furthermore, two types of hypofluorescent areas became visible from the intermediate up to the late phase: the first type was small, round, and better defined, while the second type consisted of larger, ill-defined areas seen around fixation in the right eye and temporal to fixation in the left eye. These hypofluorescent areas were not visible on either clinical examination or fluorescein angiography. Conclusions: The results of ICG angiography suggest choroidal involvement in patients with systemic lupus erythematosus-associated uveitis.

L'angiographie au vert d'indocyanine dans le „Multiple evanescent white dot syndrome” (MEWDS)

Multiple evanescent white dot syndrome (MEWDS) is a benign acquired chorioretinal disorder occurring mostly in young adults. Its pathophysiology is unknown. To describe the results of indocyanine green angiography (ICGA) in MEWDS. Four patients with MEWDS were investigated by ICGA. In all cases, ICGA revealed numerous choroidal hypofluorescent lesions that largely outnumbered the lesions visible with either fundoscopy or fluorescein angiography. Three cases showed a blind spot enlargement on perimetry associated with the presence of a large peripapillary hypofluorescent zone on ICGA. Three cases showed macular granularity on fundoscopy correlating with a significant subfoveal hypfluorescent lesion on ICGA. Evolution was always favorable with disappearance of the hypofluorescent choroidal lesions. Our results confirm that MEWDS is primarily a choroidal disorder. The blind spot enlargement and the macular granularity, frequently detected in MEWDS, result from larger peripapillary and subfoveal choroidal lesions.