title: Simultaneous indocyanine green and fluorescein angiography using a confocal scanning laser ophthalmoscope.
abstract: BACKGROUND
  Fluorescein and indocyanine green (ICG) angiography are both 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 injections.
  
  
  METHODS
  We designed a compact digital confocal scanning laser ophthalmoscope to perform true simultaneous fluorescein and ICG angiography. 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. An entire examination, including fundus photography, fluorescein angiography, and ICG angiography, could be performed in 45 minutes. It was possible to study differences in fluorescein patterns by comparing identically timed frames and to find cases in which ICG or fluorescein was optimal in visualizing retinal and subretinal structures. Confocal optical sections in the depth (z) dimension allowed viewing in different planes. It was possible to overlay ICG and fluorescein images or compare them side-by-side using a linked cursor. Digital transmission of the images was also performed.
  
  
  CONCLUSIONS
  Simultaneous ICG and fluorescein angiography can be performed rapidly, safely, and conveniently. The availability of simultaneous angiography will allow critical determination of the relative advantages and disadvantages of both types of angiography.
authors.affiliation: Department of Ophthalmology, Shiley Eye Center, University of California, San Diego, La Jolla 92093-0946, USA.
authors.forename: W R
authors.initials: WR
authors.lastname: Freeman
authors.forename: D U
authors.initials: DU
authors.lastname: Bartsch
authors.forename: A J
authors.initials: AJ
authors.lastname: Mueller
authors.forename: A S
authors.initials: AS
authors.lastname: Banker
authors.forename: R N
authors.initials: RN
authors.lastname: Weinreb
mesh_terms: D002829:Choroid / Q000098:blood supply / Q000473:pathology; D015862:Choroid Diseases / Q000175:diagnosis*; D019793:Fluorescein; D005451:Fluorescein Angiography / Q000379:methods; D005456:Fluorescent Dyes; D005654:Fundus Oculi; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007208:Indocyanine Green; D007834:Lasers; D019721:Ophthalmoscopes; D012164:Retinal Diseases / Q000175:diagnosis*; D012171:Retinal Vessels / Q000473:pathology
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green; D019793:Fluorescein