Safety of indocyanine green angiography during pregnancy - A survey of theretina, macula, and vitreous societies

Objectives: To establish current practice patterns and assess the general k nowledge among vitreoretinal-trained physicians regarding the use of indocy anine green (ICG) angiography during pregnancy, and to review the literatur e regarding the established safety of ICG angiography in pregnant women. Methods: A survey was mailed to 1101 members of the Retina, Macula, and Vit reous Societies. Results: Of the 520 respondents, 434 (83%) had seen at least 1 pregnant wom an who required ICG angiography or fluorescein angiography. Of these, 385 ( 89%) withheld fluorescein angiography and 105 (24%) withheld ICG angiograph y, largely because of fear of teratogenicity or lawsuit. Diabetic retinopat hy and choroidal neovascular membrane were the most common indications for fluorescein angiography, and choroidal neovascular membrane and choroidal t umor were the most common indications for ICG angiography. Only 24% thought that it was safe to use ICG angiography in a pregnant patient, and only 5% thought it was safer than fluorescein angiography. Conclusions: Despite the documented safety of ICG when used for retinal ang iography and the extensive experience with the use of intravenous ICG to me asure hepatic blood now in pregnant women, the results of this survey sugge st widespread hesitation to use ICG for retinal angiography in pregnant wom en. Current practice patterns regarding the use of ICG angiography in pregn ant patients may be unnecessarily restrictive.