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Carl P Herbort - One of the best experts on this subject based on the ideXlab platform.

  • Comparison of retinal and choroidal involvement in sarcoidosis-related chorioretinitis using fluorescein and Indocyanine Green Angiography
    Wolters Kluwer Medknow Publications, 2018
    Co-Authors: Ala'a El Ameen, Carl P Herbort
    Abstract:

    Purpose: To compare the involvement of the retina with that of the choroid in ocular sarcoidosis (OS) using dual fluorescein Angiography (FA)/Indocyanine Green Angiography (ICGA). Methods: A retrospective study of 23 patients with the diagnosis of OS was performed. Angiographic signs were quantified following the established FA/ICGA scoring system for uveitis. Results: The choroid was predominantly involved in 19 (82.6%) patients or 87% (40/46) of the eyes, and the retina in 2 (8.7%) patients or 13% (6/46) of the eyes. The mean angiographic score was 7.15 ± 4.5 for the retina (FA) compared to 14.02 ± 4.86 for the choroid (ICGA) (P < 0.0001). In 13% (3/23) of patients, FA did not show retinal inflammation, whereas ICGA was strongly positive, revealing occult choroidal lesions. Conclusion: The choroid is preferentially involved in OS, for which ICGA is the examination of choice. There is a risk of underestimating the global ocular involvement and of missing choroidal involvement if only FA is used. FA/ICGA scoring system allows for quantitative assessment of inflammation in the posterior uvea that occurs in OS; therefore, the system can be useful to quantitatively monitor outcomes in clinical trials

  • enhanced depth imaging is less suited than Indocyanine Green Angiography for close monitoring of primary stromal choroiditis a pilot report
    International Ophthalmology, 2017
    Co-Authors: Ozlem Balci, Carl P Herbort, Amel Gasc, Bruno Jeannin
    Abstract:

    The purpose of this study is to investigate the performance, utility, and precision of enhanced depth imaging optical coherence tomography (EDI-OCT) versus Indocyanine Green Angiography (ICGA) in tracking any fluctuation in the activity of stromal choroiditis in response to therapeutic interventions during long-term follow-up. Patients with a diagnosis of Vogt–Koyanagi–Harada (VKH) disease or birdshot retinochoroiditis (BRC), with untreated initial disease, and having had long-term follow-up, including both ICGA and EDI-OCT, were recruited at the Centre for Ophthalmic Specialised care, Lausanne, Switzerland. Angiography signs were quantified according to established dual fluorescein Angiography (FA) and ICGA scoring systems for uveitis. Changes in ICGA score and EDI choroidal thickness, in response to therapeutic intervention, were assessed. In the four eyes analysed (2 BRC and 2 VKH), mean EDI-OCT choroidal thickness decreased from 672 ± 101 µm at presentation to 358.5 ± 44.5 µm in a mean of 26.5 months, i.e. the time taken to stabilize the disease. Mean ICGA scores decreased from 28 ± 4.2 at presentation to 5 ± 7 at stabilization. Only ICGA was sufficiently sensitive and reactive having the ability to detect disease recurrences and efficacy or the absence of effect of successive treatment changes, detected in seven instances during follow-up, not recorded by EDI-OCT. This pilot study showed that ICGA was a more sensitive methodology, which promptly identifies evolving subclinical and occult choroidal disease, and flag occult recurrence and/or therapeutic responses that were otherwise missed by EDI-OCT. Although choroidal thickness was proportional to treatment course, demonstrating a linear decrease, these changes were too sluggish to be relied upon for close follow-up and timely adjustment of therapy.

  • contribution of dual fluorescein and Indocyanine Green Angiography to the appraisal of presumed tuberculous chorioretinitis in a non endemic area
    Journal of ophthalmic and vision research, 2017
    Co-Authors: Raphael Massy, Carl P Herbort
    Abstract:

    Purpose: To assess the respective involvement of retina versus choroid in presumed ocular tuberculosis (POT) in a non-endemic area using dual fluorescein (FA) and Indocyanine Green Angiography (ICGA). Methods: We retrospectively analyzed cases diagnosed with POT at the Centre for Ophthalmic Specialized Care, Lausanne, Switzerland. Angiography signs were quantified using an established dual FA and ICGA scoring system for uveitis. Results: Out of 1739 uveitis patients visited from 1995 to 2014, 53 (3%) were diagnosed with POT; of whom 28 patients (54 eyes) had sufficient data available to be included in this study. Of 54 affected eyes, 39 showed predominant choroidal involvement, 14 showed predominant retinal involvement and one had equal retinal and choroidal scores. Mean angiographic score was 6.97 ± 5.08 for the retina versus 13.48 ± 7.06 for the choroid (P Conclusion: These results represent the first report of the respective contributions of retinal and choroidal involvement in POT. Choroidal involvement was more common, for which ICGA is the preferred examination. In cases of compatible uveitis with positive results of an interferon-gamma release assay, particularly in a region that is non-endemic for TB, dual FA and ICGA should be performed to help establish the diagnosis of ocular tuberculosis and improve follow-up.

  • Indocyanine Green Angiography icga is essential for the early diagnosis of birdshot chorioretinopathy
    Klinische Monatsblatter Fur Augenheilkunde, 2012
    Co-Authors: Marina Papadia, Carl P Herbort
    Abstract:

    Background: Birdshot chorioretinitis (BC) is a rare disease involving the retina and the choroid independently. The hallmark for BC is the presence of depigmented oval lesion of the choroid, the so called “birdshot lesions”, however in the early phase of disease these lesions are often not visible. Methods: A retrospective analysis of BC patients that were investigated in Centre for Ophthalmic Specialised Care, Lausanne, Switzerland between 1995 and 2010 was performed. Patients seen in the initial phase of BC disease devoid of a specific diagnosis when referred were included. Clinical investigations along with fluorescein Angiography (FA), Indocyanine Green Angiography (ICGA) and visual field testing (VF) were analysed. Results: Three out of 7 patients (43 %) seen in the initial phase of the disease devoid of a diagnosis at presentation were analysed. These patients presented with no “birdshot” lesions whatsoever. All three patients were HLA-A29 positive, presented with vitreitis and retinal vasculitis on FA. On ICGA, all 3 patients presented bilateral evenly distributed choroidal hypofluorescent dark dots (HDD) representing choroidal granulomas. Conclusions: ICGA, by providing occult information on the choroid, is an essential tool for early diagnosis of BC. Because ICGA is still not universally practiced in uveitis centres early disease is often missed, its diagnosis delayed and proper treatment started late.

  • tuberculosis related choriocapillaritis multifocal serpiginous choroiditis follow up and precise monitoring of therapy by Indocyanine Green Angiography
    International Ophthalmology, 2012
    Co-Authors: Giulia De Luigi, Marina Papadia, Alessandro Mantovani, Carl P Herbort
    Abstract:

    To report the case of a patient initially diagnosed with acute posterior multifocal placoid pigment epitheliopathy (APMPPE), characterized by relentless evolution despite high-dose steroid therapy. An interferon-gamma release assay (IGRA) indicated a diagnosis of suspected tuberculous choriocapillaritis and the disease responded only to massive inflammation suppressive therapy and antibiotic therapy. Case report. Review of clinical features and investigational procedures. Smoldering relentless evolution and subsequent arrest of progression could be precisely monitored by Indocyanine Green Angiography (ICGA). The patient did not recover after standard anti-tubercolosis (TB) therapy combined with corticosteroid. A fourth antibiotic had to be added in order to stop the progression of the retinal disease. In each case of choriocapillaritis such as APMPPE an infectious cause including TB has to be excluded making IGRA tests unavoidable. As the main structure involved is the choriocapillaris the most precise follow-up or monitoring is obtained with ICGA.

Yuichiro Ogura - One of the best experts on this subject based on the ideXlab platform.

  • densitometry of choroidal vessels in eyes with and without central serous chorioretinopathy by wide field Indocyanine Green Angiography
    American Journal of Ophthalmology, 2016
    Co-Authors: Shuichiro Hirahara, Tsutomu Yasukawa, Aoi Kominami, Miho Nozaki, Yuichiro Ogura
    Abstract:

    Purpose To develop a new method to quantify the choroidal vessel density by binarizing ultra-wide-field Indocyanine Green Angiography (ICGA) images and determine whether values are altered in diseased eyes. Design Reliability and validity analysis. Methods Ultra-wide-field fluorescein Angiography (FA) and ICGA images were obtained using an ultra-wide-field imaging device (Optos California ultra-wide-field imaging device; Dunfermline, Scotland, UK) in 11 eyes of 11 patients without chorioretinal diseases. The angiographic signals of the choroidal vessels were determined by subtracting those of the retinal vasculature and optic disc on the FA images from the ICGA images, binarized by Niblack's method, and the choroidal vessel density calculated. Reproducibility of the method was assessed by calculating the coefficient of variance, coefficient of repeatability, and intraclass correlation coefficient. The relationships between age, spherical equivalent refractive error (SERE), and intraocular pressure and the vasculature density were assessed. To investigate possible impacts of chorioretinal diseases on the vasculature density, 10 eyes of 7 patients with central serous chorioretinopathy (CSC) were compared with the 11 control eyes. Results Choroidal vessels were contrasted by binarizing ICGA images. The method to quantify the choroidal vessel density showed high reproducibility. The SERE was correlated significantly (r = 0.573, P P Conclusions Binarization of ultra-wide-field ICGA images enabled quantification of the choroidal vessel density, which was altered in eyes with CSC. This method of measuring the choroidal vessel density may provide new insights into diagnosing and treating chorioretinal diseases.

  • understanding Indocyanine Green Angiography in polypoidal choroidal vasculopathy the group experience with digital fundus photography and confocal scanning laser ophthalmoscopy
    Retina-the Journal of Retinal and Vitreous Diseases, 2014
    Co-Authors: Chui Ming Gemmy Cheung, Timothy Y Y Lai, Shihjen Chen, Victor Chong, Won Ki Lee, Hla Myint Htoon, Yuichiro Ogura, Tien Yin Wong
    Abstract:

    Purpose:To evaluate the angiographic features in using fundus camera–based versus confocal scanning laser ophthalmoscope (cSLO)-based Indocyanine Green Angiography in differentiating polypoidal choroidal vasculopathy (PCV) from typical age-related macular degeneration.Methods:Sixty-five eyes of 44 p

  • understanding Indocyanine Green Angiography in polypoidal choroidal vasculopathy the group experience with digital fundus photography and confocal scanning laser ophthalmoscopy
    Retina-the Journal of Retinal and Vitreous Diseases, 2014
    Co-Authors: Chui Ming Gemmy Cheung, Timothy Y Y Lai, Shihjen Chen, Victor Chong, Won Ki Lee, Hla Myint Htoon, Yuichiro Ogura, Wei Yan Ng, Tien Yin Wong
    Abstract:

    Purpose: To evaluate the angiographic features in using fundus camera–based versus confocal scanning laser ophthalmoscope (cSLO)-based Indocyanine Green Angiography in differentiating polypoidal choroidal vasculopathy (PCV) from typical age-related macular degeneration. Methods: Sixty-five eyes of 44 patients with exudative maculopathy due to PCV or typical age-related macular degeneration were prospectively imaged with Indocyanine Green Angiography using fundus camera and cSLO. Images were graded independently by retinal specialists. The main outcome measure was agreement between cSLO and fundus camera for the diagnosis of PCV. The rate of detection and area under the receiver operating characteristic curve of 7 preselected individual features were also compared. Results: The diagnosis of PCV was made with the cSLO system in 36 eyes (55.4%) and typical age-related macular degeneration in 29 eyes (44.6%), whereas the fundus camera diagnosed PCV in 39 eyes (60.0%) and typical age-related macular degeneration in 26 eyes (40.0%). There was moderate agreement between the two Indocyanine Green Angiography systems (Kappa = 0.53). Using cSLO as the gold standard, fundus camera has a sensitivity and specificity of 83.3% and 69.0%, respectively. Typical nodular appearance was the most commonly detected feature (median, 88.9% for cSLO, 80.6% for fundus camera, P = 0.63) and had the highest area under the curve for the diagnosis of PCV in both systems (median, 80.2% for cSLO, 73.2% for fundus camera, P = 0.13). Confocal scanning laser ophthalmoscope was more sensitive in detecting branching vascular network and late hyperfluorescent plaque. Conclusion: Both systems detected >80% of PCV based on typical nodular appearance of polyps. However, the cSLO is superior in detecting additional features, particularly branching vascular network.

  • Indocyanine Green Angiography guided laser photocoagulation combined with sub tenon s capsule injection of triamcinolone acetonide for idiopathic macular telangiectasia
    British Journal of Ophthalmology, 2010
    Co-Authors: Yoshio Hirano, Miho Nozaki, Tsutomu Yasukawa, Yoshimi Usui, Yuichiro Ogura
    Abstract:

    AIMS Type 2 (perifoveal) telangiectasia often is refractory to treatment, because focal targets such as aneurysms are not detected by fluorescein Angiography (FA) in these eyes. The authors evaluated the efficacy of Indocyanine Green Angiography (IA)-guided laser photocoagulation and sub-Tenon's capsule injection of triamcinolone acetonide (STTA) for idiopathic macular telangiectasia. METHODS Seven eyes (seven patients; mean age, 72 years) were enrolled, five eyes with type 1 and two eyes with type 2. The mean follow-up was 10.6 months (range 7 to 19). FA and IA were performed with the Heidelberg Retina Angiogram 2. Laser photocoagulation was applied to leaky vessels detected by late-phase IA (wavelength, 577 nm; power, 100-200 mW; spot size, 100-200 microm; and duration, 0.2 s). STTA (20 mg) was injected after photocoagulation. The central macular thickness and macular volume were measured periodically by optical coherence tomography. The logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) was measured. RESULTS IA identified leaky aneurysms or vessels. The final mean logMAR VA and the central macular thickness improved significantly from baseline (p=0.040, p=0.0002, respectively). The VA improved by 0.3 or more logMAR unit in two eyes (29%) and stabilised in five eyes (71%). No adverse effects were reported throughout follow-up. CONCLUSIONS IA can detect microangiopathy in eyes with idiopathic macular telangiectasia. IA-guided laser photocoagulation combined with STTA might be effective for treating types 1 and 2 idiopathic macular telangiectasia. Further studies are needed to access the efficacy of IA-guided photocoagulation for treating type 2 telangiectasia.

Nagahisa Yoshimura - One of the best experts on this subject based on the ideXlab platform.

  • sensitivity and specificity of detecting reticular pseudodrusen in multimodal imaging in japanese patients
    Retina-the Journal of Retinal and Vitreous Diseases, 2013
    Co-Authors: Naoko Uedaarakawa, Akitaka Tsujikawa, Kenji Yamashiro, Sotaro Ooto, Akio Oishi, Nagahisa Yoshimura
    Abstract:

    Purpose To identify reticular pseudodrusen (RPD) in age-related macular degeneration using multiple imaging modalities, including the blue channel image of fundus photography, infrared reflectance (IR), fundus autofluorescence, near-infrared fundus autofluorescence, confocal blue reflectance, Indocyanine Green Angiography, and spectral-domain optical coherence tomography (SD-OCT), and to compare the sensitivities and specificities of these modalities for detecting RPD. Methods This study included 220 eyes from 114 patients with newly diagnosed age-related macular degeneration. Patients underwent fundus photography, IR, fundus autofluorescence, near-infrared fundus autofluorescence, confocal blue reflectance, Indocyanine Green Angiography, and SD-OCT in both eyes. Eyes were diagnosed with RPD if they showed reticular patterns on at least two of the seven imaging modalities. Results Thirty-seven eyes were diagnosed with RPD. However, SD-OCT and IR had the highest sensitivity (94.6%), and at the same time, SD-OCT had a high specificity (98.4%). The blue channel of color fundus photography, confocal blue reflectance, and Indocyanine Green Angiography had a specificity of 100% but had lower sensitivity than that of SD-OCT and IR. Conclusion For detecting RPD, IR and SD-OCT had the highest sensitivity. Although SD-OCT had the highest sensitivity and specificity, RPD detection should be confirmed using more than one modality for increased accuracy.

  • punctate hyperfluorescent spots associated with central serous chorioretinopathy as seen on Indocyanine Green Angiography
    Retina-the Journal of Retinal and Vitreous Diseases, 2010
    Co-Authors: Akitaka Tsujikawa, Yumiko Ojima, Kenji Yamashiro, Sotaro Ooto, Hiroshi Tamura, Satoko Nakagawa, Nagahisa Yoshimura
    Abstract:

    PURPOSE The purpose of this study was to examine Indocyanine Green Angiography of eyes with central serous chorioretinopathy (CSC). METHODS We retrospectively studied the medical records of 39 patients (41 eyes) with active CSC who were <50 years of age. All patients had undergone fluorescein Angiography and Indocyanine Green Angiography using a confocal laser scanning system. RESULTS On Indocyanine Green Angiography, most patients showed choroidal abnormalities, such as filling delay, venous dilation, subretinal leakage, or focal areas of hyperfluorescence, that were attributed to choroidal vascular hyperpermeability. In addition, punctate hyperfluorescent spots were seen in 38 of 41 eyes (93%) with active CSC and in 29 of 37 fellow eyes (78%); these spots were seen in the macular area and outside the vascular arcade or in peripapillary locations, and they often appeared as clusters of distinct spots. A cluster of punctate hyperfluorescent spots was seen on midphase Indocyanine Green Angiography, and focal areas of hyperfluorescence often appeared to expand with time from these punctate hyperfluorescent spots. CONCLUSION Focal areas of hyperpermeability in CSC may be derived from the leakage of tiny punctate spots in the inner choroid. Hyperpermeability of these lesions may be involved in the development of serous retinal detachment associated with CSC.

  • Indocyanine Green Angiography guided photodynamic therapy for polypoidal choroidal vasculopathy
    American Journal of Ophthalmology, 2007
    Co-Authors: Atsushi Otani, Akitaka Tsujikawa, Hiroshi Tamura, Manabu Sasahara, Yuko Yodoi, Hiroko Aikawa, Nagahisa Yoshimura
    Abstract:

    Purpose To report the 12-month follow-up results of subfoveal polypoidal choroidal vasculopathy (PCV) patients treated with Indocyanine Green Angiography (ICGA)-guided photodynamic therapy (PDT). Design Interventional, noncomparative cases series. Methods A retrospective analysis of the clinical and angiographic data related to 47 PCV eyes that were followed up for 12 months was carried out. The greatest linear dimension (GLD) for PDT was determined based on the ICGA findings. Optical coherence tomography (OCT) also was used to evaluate the therapeutic effects. Results The mean logarithm of the minimum angle of resolution visual acuity (VA; 0.58 ± 0.37) significantly improved to 0.53 ± 0.38 at three months (P = .04) and to 0.46 ± 0.40 at 12 months (P = .02). The average ICGA GLD (2682.3 ± 1026.9 mm) was significantly (P = .0001) smaller than the presumed fluorescein Angiography (FA) GLD (4043.6 ± 1914.8 mm). In more than 80% of cases, complete resolution of retinal exudative changes was observed. Although polypoidal vascular lesions disappeared in 82.2% of eyes, the branched vascular networks showed little change. The initial VA and GLD had little correlation with the VA outcome. Conclusions ICGA-guided PDT reduces the size of laser exposure and is an effective treatment for PCV. Because PCV may appear as occult choroidal neovascularization (CNV) on FA, PCV should be diagnosed using ICGA before treatment because PCV may respond differently than CNV to appropriate treatment.

Lawrence A. Yannuzzi - One of the best experts on this subject based on the ideXlab platform.

  • foveal exudate and choroidal neovascularization in atypical cases of multiple evanescent white dot syndrome
    Retina-the Journal of Retinal and Vitreous Diseases, 2017
    Co-Authors: Kevin Chen, Lawrence A. Yannuzzi, Sarah Mrejen, Marcela Marsiglia, Rosa Dolzmarco, Sarwar Zahid, Jose S Pulido, Salomon Y Cohen, Benjamin Freilich, Bailey K Freund
    Abstract:

    PURPOSE To describe atypical cases of multiple evanescent white dot syndrome (MEWDS) associated with foveal exudation, increased choroidal thickness, and secondary Type 2 (subretinal) neovascularization. METHODS Four cases of atypical MEWDS were studied at a retina referral center. Patients underwent evaluation with multimodal retinal imaging, including fluorescein Angiography, Indocyanine Green Angiography, spectral-domain and enhanced depth imaging optical coherence tomography (OCT). Two patients were imaged with OCT Angiography. RESULTS Four patients (3 female, 1 male) with a median age of 23.5 years presented with acute onset, painless, decreased central vision. All cases demonstrated fundus findings consistent with MEWDS on color photography, Indocyanine Green Angiography, fluorescein Angiography, fundus autofluorescence, and structural OCT imaging. On structural OCT, all 4 patients were noted to have hyperreflective subretinal material and increased subfoveal choroidal thickness ranging from 307 μm to 515 μm. Type 2 neovascularization was diagnosed in all four patients using fluorescein Angiography, Indocyanine Green Angiography, and/or OCT Angiography. Two patients had poor visual acuity at the last follow-up despite resolution of characteristic clinical findings of MEWDS. CONCLUSION A subset of patients with atypical MEWDS may develop persistent poor vision due to subfoveal exudation and secondary Type 2 neovascularization. Patients showing increased choroidal thickness at presentation may be more susceptible to this unusual presentation.

  • sequenced combined intravitreal triamcinolone and Indocyanine Green Angiography guided photodynamic therapy for retinal angiomatous proliferation
    Archives of Ophthalmology, 2006
    Co-Authors: Bailey K Freund, John A. Sorenson, Christina M Klais, Chiara M Eandi, Michael D Ober, Daniel E Goldberg, Lawrence A. Yannuzzi
    Abstract:

    Objective To study sequenced combined therapy using intravitreal triamcinolone acetonide followed by photodynamic therapy for the treatment of retinal angiomatous proliferation. Methods Patients newly diagnosed as having retinal angiomatous proliferation underwent intravitreal triamcinolone injection to reduce intraretinal and subretinal exudation, followed 7 to 14 days later by Indocyanine Green Angiography–guided photodynamic therapy with verteporfin. Complete ocular examination, fluorescein Angiography, Indocyanine Green Angiography, and optical coherence tomography were performed at baseline and at standard intervals thereafter. Results Twenty-seven eyes of 26 patients underwent this sequenced combined treatment and were followed up for 12 months. The triamcinolone injection reduced the cystoid edema before photodynamic therapy. Complete resolution of the angiographic leakage was achieved in 89% of eyes. Visual acuity improved in 37% and was stable in 52% of eyes. Eight eyes developed recurrent leakage after 3 to 11 months. Complete resolution of leakage was observed after subsequent treatment. Conclusions This sequenced combined treatment in patients with retinal angiomatous proliferation was effective in reducing or eliminating the edema, achieving rapid regression of neovascularization, and stabilizing or improving visual acuity. To our knowledge, no study to date has achieved such promising results in the management of retinal angiomatous proliferation. A randomized clinical trial is under way to compare sequential and simultaneous combined therapy.

  • multiple evanescent white dot syndrome
    Archives of Ophthalmology, 2006
    Co-Authors: Nicole E Gross, Richard F. Spaide, Lawrence A. Yannuzzi, Bailey K Freund, Gian Paolo Amato, Ruth Sigal
    Abstract:

    Objectives To study the clinical and angiographic features of lesions in a case series of multiple evanescent white dot syndrome (MEWDS), to describe a newly recognized clinical variation of the disorder, and to gain insight into its pathophysiological nature. Methods Five patients with MEWDS (selected based on angiographic manifestations of the disorder) were examined using slitlamp biomicroscopy and studied using fluorescein Angiography and Indocyanine Green Angiography. Results All 5 patients exhibited the newly recognized angiographic features termed dots and spots , which varied in size and location in the fundus. Small dots were in the inner retina or at the level of the retinal pigment epithelium, and larger spots were more external in the subpigment epithelial area. All patients exhibited other characteristics typical of MEWDS, including field loss and foveal granularity. Conclusions In this case series of MEWDS, a clinical variant consisting of dual-layered lesions with specific features on clinical examination, fluorescein Angiography, and Indocyanine Green Angiography was identified. On late Indocyanine Green Angiography, these lesions produced highly specific findings of small hypofluorescent lesions overlying larger hypofluorescent lesions. Based on the angiographic findings, it seems as if MEWDS is a chorioretinopathy with varying degrees of retinal and choroidal involvement.

  • Indocyanine Green Angiography of multifocal choroiditis
    Ophthalmology, 1997
    Co-Authors: Jason S. Slakter, Richard F. Spaide, Lawrence A. Yannuzzi, David R. Guyer, John A. Sorenson, Alfonso Giovannini, Baldo Scassellatisforzolini, Dennis A. Orlock
    Abstract:

    Abstract Purpose: The purpose of the study is to determine Indocyanine Green (ICG) angiographic characteristics of patients with multifocal choroiditis (MC) and to identify features that may assist in the differentiation of MC from other ocular inflammatory diseases. Methods: After complete ophthalmologic examination, fluorescein Angiography and ICG Angiography were performed in a series of 14 patients with MC. The ICG findings were then correlated with the clinical and fluorescein angiographic appearance of these patients to determine specific characteristics and distinguishing features of the entity. These findings then were compared with those of angiographic patterns observed in patients with ocular histoplasmosis syndrome to determine whether differentiating features could be identified. Results: Fourteen (50%) of the 28 eyes were found to have large hypofluorescent spots in the posterior pole on ICG Angiography, which, in most cases, did not correspond to clinically or fluorescein angiographically detectable lesions. Seventeen (61%) had smaller hypofluorescent lesions (approximately 50 µm in size) in the posterior pole on the ICG study. In seven eyes exhibiting enlarged blind spots on visual field testing, ICG Angiography showed confluent hypofluorescence surrounding the optic nerve. The ICG angiogram was found useful in evaluating the natural course in two patients with MC as well as a response to oral prednisone therapy in four others. The ICG angiographic findings differed from those seen in patients with ocular histoplasmosis. Conclusions: Indocyanine Green Angiography can provide information that is not detectable by clinical or fluorescein angiographic examination in patients with MC. This information may prove useful in differentiating this condition from the ocular histoplasmosis syndrome, provide a better understanding of the natural course and progression of the disease, and provide a potential adjunct in the clinical evaluation of patients undergoing therapeutic regimens for active inflammatory lesions.

  • Indocyanine Green Angiography
    1997
    Co-Authors: Jason S. Slakter, Lawrence A. Yannuzzi, David R. Guyer, John A. Sorenson, Dennis A. Orlock
    Abstract:

    Indocyanine-Green Angiography represents a major advance in imaging of the choroidal circulation. Recent technical innovations have permitted this diagnostic technique to find clinical application in many chorioretinal conditions. The Indocyanine-Green molecule has proven to be safe for human study.

Tien Yin Wong - One of the best experts on this subject based on the ideXlab platform.

  • understanding Indocyanine Green Angiography in polypoidal choroidal vasculopathy the group experience with digital fundus photography and confocal scanning laser ophthalmoscopy
    Retina-the Journal of Retinal and Vitreous Diseases, 2014
    Co-Authors: Chui Ming Gemmy Cheung, Timothy Y Y Lai, Shihjen Chen, Victor Chong, Won Ki Lee, Hla Myint Htoon, Yuichiro Ogura, Tien Yin Wong
    Abstract:

    Purpose:To evaluate the angiographic features in using fundus camera–based versus confocal scanning laser ophthalmoscope (cSLO)-based Indocyanine Green Angiography in differentiating polypoidal choroidal vasculopathy (PCV) from typical age-related macular degeneration.Methods:Sixty-five eyes of 44 p

  • understanding Indocyanine Green Angiography in polypoidal choroidal vasculopathy the group experience with digital fundus photography and confocal scanning laser ophthalmoscopy
    Retina-the Journal of Retinal and Vitreous Diseases, 2014
    Co-Authors: Chui Ming Gemmy Cheung, Timothy Y Y Lai, Shihjen Chen, Victor Chong, Won Ki Lee, Hla Myint Htoon, Yuichiro Ogura, Wei Yan Ng, Tien Yin Wong
    Abstract:

    Purpose: To evaluate the angiographic features in using fundus camera–based versus confocal scanning laser ophthalmoscope (cSLO)-based Indocyanine Green Angiography in differentiating polypoidal choroidal vasculopathy (PCV) from typical age-related macular degeneration. Methods: Sixty-five eyes of 44 patients with exudative maculopathy due to PCV or typical age-related macular degeneration were prospectively imaged with Indocyanine Green Angiography using fundus camera and cSLO. Images were graded independently by retinal specialists. The main outcome measure was agreement between cSLO and fundus camera for the diagnosis of PCV. The rate of detection and area under the receiver operating characteristic curve of 7 preselected individual features were also compared. Results: The diagnosis of PCV was made with the cSLO system in 36 eyes (55.4%) and typical age-related macular degeneration in 29 eyes (44.6%), whereas the fundus camera diagnosed PCV in 39 eyes (60.0%) and typical age-related macular degeneration in 26 eyes (40.0%). There was moderate agreement between the two Indocyanine Green Angiography systems (Kappa = 0.53). Using cSLO as the gold standard, fundus camera has a sensitivity and specificity of 83.3% and 69.0%, respectively. Typical nodular appearance was the most commonly detected feature (median, 88.9% for cSLO, 80.6% for fundus camera, P = 0.63) and had the highest area under the curve for the diagnosis of PCV in both systems (median, 80.2% for cSLO, 73.2% for fundus camera, P = 0.13). Confocal scanning laser ophthalmoscope was more sensitive in detecting branching vascular network and late hyperfluorescent plaque. Conclusion: Both systems detected >80% of PCV based on typical nodular appearance of polyps. However, the cSLO is superior in detecting additional features, particularly branching vascular network.