INDOCYANINE GREEN ANGIOGRAPHY OF MULTIFOCAL CHOROIDITIS

Purpose: The purpose of the study is to determine indocyanine green (I CG) angiographic characteristics of patients with multifocal choroidit is (MC) and to identify features that may assist in the differentiatio n of MC from other ocular inflammatory diseases. Methods: After comple te ophthalmologic examination, fluorescein angiography and ICG angiogr aphy were performed in a series of 14 patients with MC, The ICG findin gs were then correlated with the clinical and fluorescein angiographic appearance of these patients to determine specific characteristics an d distinguishing features of the entity. These findings then were comp ared with those of angiographic: patterns observed in patients with oc ular histoplasmosis syndrome to determine whether differentiating feat ures could be identified. Results: Fourteen (50%) of the 28 eyes were found to have large hypofluorescent spots in the posterior pole on ICG angiography, which, in most cases, did not correspond to clinically o r fluorescein angiographically detectable lesions. Seventeen (61%) had smaller hypofluorescent lesions (approximately 50 mu m in size) in th e posterior pole on the ICG study. In seven eyes exhibiting enlarged b lind spots on visual field testing, ICG angiography showed confluent h ypofluorescence surrounding the optic nerve. The ICG angiogram was fou nd useful in evaluating the natural course in two patients with MC as well as a response to oral prednisone therapy in four others. The ICG angiographic findings differed from those seen in patients with ocular histoplasmosis. Conclusions: indocyanine green angiography can provid e information that is not detectable by clinical or fluorescein angiog raphic examination in patients with MC. This information may prove use ful in differentiating this condition from the ocular histoplasmosis s yndrome, provide a better understanding of the natural course and prog ression of the disease, and provide a potential adjunct in the clinica l evaluation of patients undergoing therapeutic regimens for active in flammatory lesions.