Ten years experience with choroidal angiography using indocyanine green dye: a new routine examination or an epilogue?

The choroidal circulation can be studied by an angiographic technique which utilizes near-infrared light wavelengths and a biocompatible dye, indocyanine green (CardiogreenR). Near-infrared light is less absorbed than visible light by the pigment epithelium and the macular xanthophyll, and indocyanine green (ICG) dye doesn't leak from the choriocapillaris as sodium fluorescein dye typically does. Due to the high rate of choroidal blood flow, a fundus camera adapted with special filters and a continuous light source was used in order to make angiograms at the rate of 10 per second. Our experience at the Wilmer Institute and the Eye Clinic at St. Gallen includes 180 choroidal angiograms of normal volunteers and approximately 500 choroidal angiograms of patients with several fundus diseases, mainly senile macular degeneration, diabetic retinopathy and choroidal tumors. Although many of our results are preliminary, we present them to demonstrate the potential applications of this method in ophthalmology. Some factors which may have inhibited an extensive propagation of clinical choroidal angiography in the past are also discussed.