Retinal toxicity of indocyanine green.
OBJECTIVE
To describe a case of scattered toxicity of indocyanine green on the outer retina and retinal pigment epithelium (RPE) after indocyanine green (ICG) assisted membrane peeling for macular pucker.


METHODS
A 61-year-old woman was examined by slit-lamp biomicroscopy, fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT), 1 month and 1 year after ICG assisted membrane peeling for macular pucker.


RESULTS
In the absence of significant fundoscopic changes, we have noted on FA and ICGA an occurrence of scattered unusual outer retinal and pigment epithelial changes at the 1- and the 12-month follow-up, probably due to the enhanced phototoxicity associated with the use of ICG at a high concentration (0.5%).


CONCLUSIONS
Retinal toxicity of ICG in macular surgery depends on many factors. In our patient, the retinal changes seem to have been caused by a combination of all the toxic factors. This is the first reported case describing both the angiographic and OCT patterns of diffuse scattered toxicity of ICG on outer retinal layers and pigment epithelium after ICG assisted membrane peeling for macular pucker.
Querques
Giuseppe
G
Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Viale Pinto, 1, Foggia 71100, Italy. giuseppe.querques@hotmail.it
Prascina
Francesco
F
Iaculli
Cristiana
C
Noci
Nicola Delle
ND
D004396:Coloring Agents / Q000009:adverse effects*; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green / Q000009:adverse effects*; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000187:drug effects; D012160:Retina / Q000187:drug effects* / Q000473:pathology; D041623:Tomography, Optical Coherence
D004396:Coloring Agents; D007208:Indocyanine Green