Sensitivity of indocyanine green angiography for the follow-up of active inflammatory choriocapillaropathies

Background: Inflammatory choriocapillaropathies (choriocapillaritis) corres pond to the clinical spectrum of lesions of the fundus, including acute pos terior multifocal placoid pigment epitheliopathy (APMPPE), multiple evanesc ent white dot syndrome (MEWDS), multifocal choroiditis (MC), and other rare r entities caused by inflammatory disturbances of choriocapillaris perfusio n. The aim here was to study the sensitivity of indocyanine green (ICG) ang iography in investigating and following inflammatory choriocapillaropathies . Patients and methods: Patients with inflammatory choriocapillaropthies we re included who had had a dual fluorescein and ICG angiography as well as v isual field testing (Goldman or computerized perimetry) at presentation and on follow-up visits. ICG angiography was performed according to a routine angiographic protocol used for inflammatory diseases and was correlated wit h fundus examination, fluorescein angiography, and visual field testing. Re sults: Three patients with MEWDS, two with APMPPE, and two with MC were inc luded. The visual field alterations in all seven patients were well correla ted with the extent of the hypofluorescent areas seen on ICG angiography, w hereas they were badly correlated with fluorescein angiographic signs and t heir evolution. The visual field in MEWDS was particularly well correlated with the importance of peripapillary hypofluorescence seen on ICG angiograp hy. In MC, the evolution of new lesions was well demonstrated by ICG angiog raphy and well correlated with visual symptoms and visual fields, but was b arely detected on fundus examination and by fluorescein angiography. Conclu sions: ICG angiographic signs were shown to be closely correlated with visu al function (visual field testing). This was not the case for either fundus examination or fluorescein angiography. ICG angiography appears as a very sensitive follow-up parameter in inflammatory choriocapillaropathies, givin g morphological information on the evolution of the disease and on the resp onse to treatment when therapy is indicated.