OBSERVATIONS OF THE CHOROIDAL PULSATION

Background While performing indocyanine-green (ICG) videoangiograms wi th the Rodenstock scanning laser ophthalmoscope (SLO), we got more and more aware of a visible choroidal pulsation mainly during the inflow of ICG into the eye. We wanted to learn more about the frequency and t he different forms of this phenomenon. Material and methods We examine d 187 consecutive ICG angiographies retrospectively. which were perfor med with a Rodenstock SLO and stored by videotape. Most patients suffe red from age-related macular degeneration and had a mean age of about 70 years. We defined 4 groups of different pulsatile dye inflow in the choroid, namely (group 1) the diffuse form, involving the whole macul ar region, (group 2) the local form, involving an area smaller than th e fovea. In group 3 (mixed form) we found the pulsatile inflow diffuse initially, later on remained a local pulsation. In group 4 (special f orm) we noticed a localized pulsation of a longer duration (10-15 seco nds) and of a special type, namely back and forth movements of dye in one or a few choroidal veins. In addition, we examined the presence of pulsation in the central retinal vein. Results In 173 of 187 angiogra ms we could examine the choroidal inflow in the macular region. We fou nd in 94 of these 173 angiograms (or in 54%) choroidal pulsation. 84% of all cases were in group 1, 2 and 3. This probably physiological pul sation occured mostly in the first few seconds after the inflow of the dye, After about 5 seconds it was normally not visible any more. In o ur group 4 we collected 16 out of 94 angiograms (or 17%). We could not find a correlation between the presence of a pulsation in the central vein and in the choroid. Conclusions Choroidal pulsatile inflow of IC G is a frequent (most probably physiological) phenomenon. The localize d pulsation found in several older patients with back and forth moveme nts of dye in one or a few veins may be abnormal; it reflects phasic p ressure changes in choroidal veins of low now. we do not know yet if t his phenomenon is of any diagnostic value. However, more studies of th ese interesting dynamic processes seem to be warranted.