This article is more than 5 years old. Information may no longer be current.

ICG angiography clinically useful as ancillary test

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

WAILEA, Hawaii – Indocyanine green angiography as an ancillary retina test is relevant in 2015 as a limited part of multimodal imaging, a presenter said.

Jay S. Duker

“What we’ve learned from OCT is that our clinical impression is sometimes wrong, and having ancillary tests like angiography or OCT or fundus autofluorescence can confirm what we believe to be true is very helpful. They can rule out mimicking conditions and also give us a list of therapeutic options we can offer the patient,”Jay S. Duker, MD,said at Retina 2015. “What we’re really talking about for the average clinical practice is, is the retina thick or thin? And is the presence of choroidal neovascularization present or absent? Those are two big decision makers.” Furthermore, ancillary testing can assess whether treatment is adequate.

As an ancillary test, indocyanine green (ICG) angiography has better absorption through pigment and blood, it is highly protein bound, which equates to less leakage from the choriocapillaris, and it avoids the allergy concerns of fluorescein. The two major conditions that ICG angiography is used to diagnose are polypoidal choroidal vasculopathy and central serous chorioretinopathy, he said.

Disadvantages of ICG angiography are that it is not widely available, it is expensive, it is contraindicated in shellfish allergies, it has no utility in dry AMD and minimal benefit in wet AMD treated with anti-VEGF monotherapy, and there is no benefit in other retinal vascular disorders, such as diabetic retinopathy and retinal vein obstruction, according to the presentation.

“So what are the indications? If you have a patient who you think has wet AMD and you’re using anti-VEGF monotherapy and not getting the response that you expect, then getting an ICG angiogram is the next step,” Duker said.

ICG angiogram can also make the diagnosis of central serous retinopathy, particularly in older patients, and it is helpful in the diagnosis of inflammatory conditions involving the RPE and choroid, he said. – by Patricia Nale

Disclosure: Duker reports being a stockholder in EyeNetra, Hemera Biosciences and Ophthotech; receiving research support from Carl Zeiss Meditec and Optovue; and being a consultant for Alcon/Novartis, Allergan, Nicox, Optos, Regeneron and Thrombogenics.