Indocyanine Green (ICG) Angiography - Blood Vessel ...
Indocyanine Green (ICG) Angiography - Blood Vessel ...
Introduction
Indocyanine green (ICG) angiography is an eye test that is used to detect blood circulation problems in the choroid. The choroid is a blood vessel layer located under the retina in the back of your eye. The test uses an injected dye and special cameras to take photos of the blood vessels. ICG is used to diagnose certain eye conditions, such as macular degeneration, or to determine if laser treatment is possible. ICG is a short procedure that is performed in a doctor's office.
Anatomy
The retina is located at the back of your eye. It is a thin tissue layer containing millions of nerve cells that are sensitive to light. The primary purpose of your eye is to focus light on the retina. The choroid, located underneath the retina, contains blood vessels supplying the retina with blood and oxygen to keep it healthy.
Cones and rods are specialized receptor cells in the retina. Cones are specialized for color and detailed vision, such as reading or identifying distant objects. They work best with bright light. The greatest concentration of cones is found in the macula and fovea at the center of the retina. The macula is the center of visual attention, and the fovea is the site of visual acuity or best visual sharpness. Rods, which are located throughout the rest of the retina, are specialized receptor cells.
Your eyes contain more rods than cones. Rods work best in low light and perceive blacks, whites, and grays but not colors. They detect general shapes and are used for night vision and peripheral vision. High concentrations of rods at the outer portions of your retina act as motion detectors in your peripheral vision.
The receptor cells in the retina send nerve messages about what you see to the optic nerve. The optic nerve extends from the back of each eye and joins together in the brain at the optic chiasm. From the optic chiasm, the nerve signals travel along two optic tracts in the brain and eventually to the occipital cortex.
Diagnosis
Uses
ICG is an eye test that detects blood vessel problems in the choroid. This test is important because some blood vessel conditions can lead to vision loss if not diagnosed and treated early. The procedure uses a harmless green dye called indocyanine green, which reflects infrared light that is picked up by a special camera. An ICG is different from a fluorescein angiography, a similar imaging test, and is often used in conjunction with a fluorescein angiogram to define a specific problem in the macula.
ICG produces detailed pictures that can show leaking blood vessels, blocked blood vessels, or vascular abnormalities. The test also determines if laser surgery is possible and helps plan it. ICG can pinpoint a blood vessel leak's exact location for lasering. ICG is used for many conditions, including age-related macular degeneration, choroid tumors, retinal detachment, retinal hemorrhage, and choroidal neovascularization.
Preparation
You will need someone to drive you home from the test because your vision will be blurred afterward. Your doctor may ask you to discontinue certain medications before the test. Inform your doctor if you are hypersensitive to iodine, allergic to X-ray dye or shellfish, pregnant, or have liver disease.
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Testing
Your doctor will dilate your pupils with eye drops and stabilize your face with a positioning device for the test. Special cameras will be used to take pictures. The dye will be injected into your vein, and your doctor will take a series of photographs as the dye moves through your blood vessels.
Your vision will be blurred for several hours after the test. Your urine will be darker than usual for a few days as the dye leaves your system. In rare cases, some people may be hypersensitive or allergic to the dye. Because the reaction can occasionally be serious, call your doctor immediately if you experience symptoms such as nausea, vomiting, dry mouth, increased saliva production, a metallic taste in your mouth, feeling dizzy or faint, hives, sneezing, or increased heart rate.
Angiography with Fluorescein and Indocyanine Green
Frequently Asked Questions
How long does the test last?
The test lasts about 10 minutes for fluoresceinography and around 40 minutes for indocyanography. Nevertheless, the total time that the patient spends at the center, from arrival to departure, is around 1 hour.
Should the test be done on an empty stomach?
You do not need to fast before the test. You should have breakfast like any other day but not eat excessively.
Should I come accompanied?
It is very important to come to the test with someone else because your vision will be temporarily blurred. Your pupil will be dilated, so you will not be able to drive after the test.
Are there any side effects?
The side effects that patients may experience from the test are a result of the pupils being dilated and may include glare and blurred vision. During the test, we can see the flashes and lights emitted by the apparatus, and occasionally, we may experience some nausea or temporary heat. In some exceptional cases, stronger sensations may be experienced.
After the test, the patient may continue to experience blurred vision for a few hours due to the dilating drops. Some patients may also notice a change in skin color or the color of their urine as the dye is eliminated through the urine.
What happens if I have an unexpected reaction to the dye?
We have a medical and nursing team trained in resuscitation available at all times in case of an emergency.
How long do the side effects last after the test?
The glare effects last as long as the eye drops' effects, which can last for around 4 hours, while the change in urine color can last for 1 to 3 days, depending on the patient's renal function.
What are the advantages of having the angiography at the ICR?
ICR has the best technology on the market. The highly versatile tool that we use can be adapted and focused depending on the patient’s illness to obtain detailed images of the internal layers of the eye. We can also combine the angiography with another test that provides a wealth of information: optical coherence tomography (OCT).
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