INTRARETINAL LEAKAGE OF INDOCYANINE GREEN-DYE

Purpose: Indocyanine green (ICG) dye is known to remain selectively in and around choroidal neovascularization (CNV) associated with age-rel ated macular degeneration, and is thought to be cleared from the overl ying retinal circulation without leakage. This is the basis of ICG dye -enhanced laser photocoagulation. The authors have observed, however, leakage of ICG dye into cystoid spaces within the retina and have dete rmined the incidence, clinical features, and angiographic characterist ics of this newly described phenomenon. Methods: The digital ICG video angiograms of 149 consecutive patients with exudative age-related macu lar degeneration and occult CNV were reviewed independently to determi ne the characteristics of intraretinal ICG dye leakage. Results: Of th e 149 patients with occult CNV, 16 (11%) demonstrated intraretinal lea kage of ICG dye between 14 and 34 minutes (median = 20 minutes). The c linical features most commonly associated with this phenomenom are: su bretinal fluid (88%), subretinal hemorrhage (88%), subretinal lipid (6 3%), and retinal pigment epithelial detachment (56%). Conclusions: Ind ocyanine green dye may not be as concentrated in and around CNV as pre viously reported. The delayed onset of its appearance within intrareti nal cystoid spaces may suggest a diffusible choroidal source of leakag e. Intraretinal ICG dye may be a relative contraindication for ICG dye -enhanced laser photocoagulation.