gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Reduction of fluorescein and indocyanine green amounts in cSLO fluorescence angiography

Meeting Abstract

  • corresponding author A. Bindewald - Department of Ophthalmology, University of Bonn, Bonn
  • F. Roth - Department of Ophthalmology, University of Bonn, Bonn
  • O. Stuhrmann - Department of Ophthalmology, University of Bonn, Bonn
  • A. Wegener - Department of Ophthalmology, University of Bonn, Bonn
  • N. Eter - Department of Ophthalmology, University of Bonn, Bonn
  • F. G. Holz - Department of Ophthalmology, University of Bonn, Bonn

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.01.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog004.shtml

Published: September 22, 2004

© 2004 Bindewald et al.
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Outline

Text

Objective

With the advent of confocal scanning laser ophthalmoscopy (cSLO) more sensitive tools are available for routine fluorescence angiography compared to conventional fundus cameras. We determined the minimal required amounts of fluorescein and indocyanine green (ICG) dye for fluorescence angiography.

Methods

Fluorescein and ICG angiography was performed in 35 patients with various retinal pathologies using a novel cSLO (Heidelberg Retina Angiograph 2, Heidelberg Engineering). The amount of fluorescein (500 mg, 250 mg, 200 mg, 166 mg) and ICG (15 mg, 10 mg, 5 mg, 2.5 mg) bolus injections was gradually tapered. Standardized acqusition of images was performed at 5, 15 and 30 min after injection. Early phase images were recorded as a series of images (16 frames/sec). For quasi-simultaneous angiography ICG was injected 2 min after fluorescein to optimize adjustments and, therefore, image quality during the early phase. Assessment of possible lens opacities was performed using a Scheimpflug camera (EAS-1000, Fa. Nidek).

Results

At amounts as low as 166 mg fluorescein in 1.6 ml sufficient image quality was achieved at all phases after injection. Only late phase images (30 min) showed somewhat less contrast which was, however, not relevant for interpretation and clinical management. For ICG angiography the lowest amount of injected dye to allow sufficient image quality was 2.5 mg in 0.5 ml.

Conclusions

Using novel confocal scanning laser systems for routine angiography amounts of injected fluorescence dye can be reduced by a third for fluorescein (166 mg) and by a sixth for ICG (2.5 mg) without relevant loss of image quality or information. This allows for potential savings especially in 'high-volume' angiographic/retinologic centers.