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Indocyanine Green Angiography

Eye Care estimated about CNY 800-1500

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Description

A diagnostic imaging technique using indocyanine green dye to visualize choroidal and deep retinal vasculature, primarily used in ophthalmology for conditions like age-related macular degeneration and choroidal neovascularization.

Main Uses

ICGA is primarily used to evaluate choroidal vasculature and pathology when standard fluorescein angiography (FA) is insufficient. Key clinical applications include: diagnosing and monitoring polypoidal choroidal vasculopathy (PCV); differentiating types of choroidal neovascularization (CNV); evaluating chronic central serous chorioretinopathy (CSC); detecting occult or inflammatory choroidal lesions (e.g., in Vogt-Koyanagi-Harada disease or sarcoidosis); assessing choroidal tumors (e.g., choroidal melanoma vs. hemangioma); and guiding photodynamic therapy (PDT) planning for CNV or PCV.

Normal Range

ICGA is a qualitative/semi-quantitative imaging test—not a blood assay with numerical 'values'. It assesses choroidal vascular dynamics via real-time near-infrared fluorescence. Normal findings include: rapid choroidal filling (within 10–15 seconds), homogeneous and intense choroidal fluorescence, well-defined choroidal vessel architecture, no leakage or pooling, and clearance of dye from the choroid by 15–30 minutes. No standardized quantitative 'normal range' exists for serum ICG concentration; plasma half-life is ~3–4 minutes, and >98% protein-bound; serum ICG levels are not clinically measured.

Low Values - Possible Causes

Low or absent choroidal fluorescence on ICGA may result from: 1) Severe choroidal hypoperfusion (e.g., in giant cell arteritis or severe hypotension); 2) Choroidal atrophy (e.g., advanced age-related choroidal thinning or choroideremia); 3) Massive subretinal hemorrhage or exudate blocking ICG signal; 4) Technical factors (e.g., incorrect dye injection timing, underdosing <0.5 mg/kg, poor camera alignment, or filter malfunction); 5) Severe hepatic dysfunction impairing ICG clearance (rarely affects early-phase imaging but may reduce peak fluorescence intensity).

High Values - Possible Causes

Increased or prolonged choroidal fluorescence on ICGA may be caused by: 1) Choroidal hyperperfusion (e.g., in inflammatory conditions like posterior scleritis or VKH syndrome); 2) Choroidal vascular leakage due to neovascularization (e.g., polypoidal choroidal vasculopathy or choroidal neovascularization); 3) Stasis or delayed drainage (e.g., in central serous chorioretinopathy—CSC—with dilated choroidal vessels); 4) Dye recirculation artifacts or overdosing (>0.7 mg/kg); 5) Reduced hepatic metabolism (e.g., cirrhosis or Gilbert syndrome), leading to prolonged systemic ICG retention and enhanced late-phase background fluorescence.

choroidal imaging retinal diagnostics

estimated about CNY 800-1500