Anterior segment indocyanine green angiography in scleral inflammation

Purpose To assess the feasibility of using indocyanine green angiography in scleral inflammation; to define the characteristic patterns of the anterio r segment vasculature for this anterior segment disease; and to correlate t he findings with those of anterior segment fluorescein angiography. Methods Anterior segment fluorescein and indocyanine green digital angiogra phy were used to evaluate scleral inflammation in 3 patients with diffuse e piscleritis, 2 patients with nodular episcleritis and 5 patients with nodul ar scleritis. Angiograms from both techniques were assessed based on the ti me for complete disappearance of the dye and the type of leakage. Results Both fluorescein and indocyanine green dye appeared in vessels at a pproximately the same time, but, whereas fluorescein had disappeared comple tely from vessels by the 70th second, indocyanine green was observed within vessels for up to 23 min. Leakage of fluorescein occurred in all patients with diffuse episcleritis but staining occurred in only 1 patient with nodu lar scleritis. No leakage of indocyanine green, or staining, occurred in pa tients with diffuse episcleritis. However, leakage of indocyanine green was apparent in all nodular episcleritis and scleritis patients, staining the nodules in patchy form. Conclusion The longer transit time, as well as leakage and staining pattern s due to its protein-binding properties, make indocyanine green angiography a potentially useful technique in the investigation of patients with scler al inflammation, and in distinguishing diffuse from nodular variants. Furth er studies are necessary to correlate staining patterns with clinical findi ngs.