Safety of Indocyanine Green Angiography During Pregnancy

Abstract

To establish current practice patterns and assess the general knowledge among vitreoretinaltrained physicians regarding the use of indocyanine green (ICG) angiography during pregnancy, and to review the literature regarding the established safety of ICG angiography in pregnant women. Methods: A survey was mailed to 1101 members of the Retina, Macula, and Vitreous Societies. Results: Of the 520 respondents, 434 (83%) had seen at least 1 pregnant woman who required ICG angiography or fluorescein angiography. Of these, 385 (89%) withheld fluorescein angiography and 105 (24%) withheld ICG angiography, largely because of fear of teratogenicity or lawsuit. Diabetic retinopathy and choroidal neovascular membrane were the most common indications

Polymer–protein hydrogel nanomatrix for stabilization of indocyanine green towards targeted fluorescence and photoacoustic bio-imaging

“…hepatic excretory function 10 , uterine blood flow 11 , lymph nodes in breast cancer 12 , atherosclerotic plaques 13 , retinal angiography 9, 14, 15 ). Apart from its use in fluorescence imaging, which is a purely optical method, ICG is also a good contrast agent for the emerging method of photoacoustic imaging (PI).…”

Review of near-infrared methods for wound assessment

“…62 Its safety for pregnant women is not well studied. 64 Adverse reactions to ICG are rare, with pruritus and mild reactions such as nausea and vomiting occurring in about 0.15% of patients. 65 More severe reactions have been reported and some deaths have occurred during cardiac catheterization in conjunction with ICG administration.…”

Specialized Diagnostic Investigations to Assess Ocular Status in Hypertensive Diseases of Pregnancy

“…There is a lot of hesitation and reluctance among health care professionals regarding the use of fluorescein and ICG angiography in pregnant patients in spite of the documented safety, particularly of ICG angiography and intravenous ICG to measure hepatic blood flow in pregnant patients [13,14]. According to Fineman et al , “both ICG and fluorescein are classified by the Food and Drug Administration as pregnancy category C, indicating that studies have not been conducted and therefore it is unknown whether fetal harm will result when administered to a pregnant woman [14].…”

“…According to Fineman et al , “both ICG and fluorescein are classified by the Food and Drug Administration as pregnancy category C, indicating that studies have not been conducted and therefore it is unknown whether fetal harm will result when administered to a pregnant woman [14]. ” In a majority of centers, fluorescein angiography and indocyanine green angiography have been done after delivery of the fetus and termination of pregnancy to avoid any possible adverse effects to the fetus or the mother.…”