BACKGROUND: With the development of new imaging technologies indocyanine green (ICG) angiography allows better visualization of choroidal and retinal vasculature and their pathology. Due to its high protein bound ICG leaks very slowly from fenestrated normal and abnormal vessels. With its absorption and emission peak in the near infrared spectrum ICG penetrates hemorrhage to a greater degree than does blue light with shorter wavelength used for fluorescein angiography. METHODS: We report the clinical and fluoresceinangiographical findings of three patients with a sudden macular hemorrhage of unknown origin. RESULTS: In all patients conventional fluoresceinangiography revealed a similar appearance with little characteristic signs early ill-defined hyperfluoroescence and late exudation of dye. ICG angiography clearly demonstrated the underlying pathology as a pulsatile retinal artery macroaneurysm, a choroidal neovascularization secondary to age-related macular degeneration, and a retinal angioma. CONCLUSION: ICG videoangiography with its absorption and emission peak in the near infrared light seems to be an additive tool to identify and delineate more precisely fluoresceinangiographically ill-defined hyperfluorescence and exudations in patients with retinal hemorrhage of unknown origin.
BACKGROUND: With the development of new imaging technologies indocyanine green (ICG) angiography allows better visualization of choroidal and retinal vasculature and their pathology. Due to its high protein bound ICG leaks very slowly from fenestrated normal and abnormal vessels. With its absorption and emission peak in the near infrared spectrum ICG penetrates hemorrhage to a greater degree than does blue light with shorter wavelength used for fluorescein angiography. METHODS: We report the clinical and fluoresceinangiographical findings of three patients with a sudden macular hemorrhage of unknown origin. RESULTS: In all patients conventional fluoresceinangiography revealed a similar appearance with little characteristic signs early ill-defined hyperfluoroescence and late exudation of dye. ICG angiography clearly demonstrated the underlying pathology as a pulsatile retinal artery macroaneurysm, a choroidal neovascularization secondary to age-related macular degeneration, and a retinal angioma. CONCLUSION:ICG videoangiography with its absorption and emission peak in the near infrared light seems to be an additive tool to identify and delineate more precisely fluoresceinangiographically ill-defined hyperfluorescence and exudations in patients with retinal hemorrhage of unknown origin.