SIMULTANEOUS INDOCYANINE GREEN AND FLUORESCEIN ANGIOGRAPHY USING A CONFOCAL SCANNING LASER OPHTHALMOSCOPE

Background: Fluorescein and indocyanine green (ICG) angiography are bo th useful in the diagnosis and treatment of many retinal diseases. In some cases, both tests must be performed for diagnosis and treatment; however, performing both is time-consuming and may require multiple in jections. Methods: We designed a compact digital confocal scanning las er ophthalmoscope to perform true simultaneous fluorescein and ICG ang iography. We report our experience using the instrument to perform 169 angiograms in 117 patients. Results: There were no unexpected adverse effects from mixing the dyes and administering them in 1 injection. A n entire examination, including fundus photography, fluorescein angiog raphy, and ICG angiography, could be performed in 45 minutes. It was p ossible to study differences in fluorescein patterns by comparing iden tically timed frames and to find cases in which ICG or fluorescein was optimal in visualizing retinal and subretinal structures. Confocal op tical sections in the depth (z) dimension allowed viewing in different planes. It was possible to overlay ICG and fluorescein images or comp are them side-by-side using a linked cursor. Digital transmission of t he images was also performed. Conclusions: Simultaneous ICG and fluore scein angiography can be performed rapidly, safely, and conveniently. The availability of simultaneous angiography will allow critical deter mination of the relative advantages and disadvantages of both types of angiography.