Assessment and classification of choroidal vasculitis in posterior uveitis using indocyanine green angiography

Abstract

ICGA allowed the hitherto impossible characterization of inflammatory involvement of the choroidal vessels, showing either predominant inflammation of the choriocapillaris or predominant inflammation of the stromal choroidal vessels with or without secondary choriocapillaritis. ICGA will be indispensable for the correct evaluation and follow-up of posterior inflammation with suspected choroidal involvement.

Indocyanine green angiography findings in initial acute pretreatment Vogt-Koyanagi-Harada disease in Japanese patients

“…7 The fl uorescence of the indocyanine green (ICG) dye occurs in the near-infrared wavelengths and can be detected through the retinal pigment epithelium, allowing imaging access to the choroidal vascular structures and the stroma. 8 Since IA has made detection of choroidal lesions possible, several reports have been published on the choroidal involvement in VKH disease. [9][10][11][12][13][14] Several IA signs have been presented in different series, but their practical value for clinical use has not been clearly determined as the patients analyzed were at different stages of disease and therapy.…”

Evaluation of Posterior Pole with Echography and Optical Coherence Tomography in Patients with Behçet’s Disease

“…Moreover, 76.8% of the hyperfluorescent and hypofluorescent lesions seen on indocyanine green angiography were not evident on fluorescein angiography, which could suggest a primary inflammation of the choroid alone. In another study the evaluation of posterior vasculitis with indocyanine green angiography during Behçet’s uveitis of recent onset showed choriocapillaris perfusion delay and fuzzy choroidal vessels without late diffuse choroidal hyperfluorescence [20]. Choroidal thickening without retinal signs is also typical of the first phases of Harada’s disease, another form of autoimmune uveitis [21].…”

Alteration in choroidal blood flow produced by local pressure

“…In CSC, focal areas of nonperfusion are observed with ICG angiography with edges of staining and leakage [13,17,18], similar to what we observed after pressure indentation. There is also evidence that other abnormalities can be due to choroidal vessel thrombosis, such as acute posterior multifocal placoid pigment epitheliopathy (APMPPE), multiple evanescent white-dot syndrome (MEWDS), and ampiginous and serpiginous choroidopathy, which present clinically with areas of hypofluorescence on ICG angiography [4,20]. In a case of APMPPE with concurrent cerebral vasculitis, histopathology revealed thrombo-obliterative vasculitis of the medium-sized arterial branches of the leptomeninges, implying that similar thrombotic changes may also be occurring in the choroid [23].…”