Imaging and evaluation of corneal vascularization using fluorescein and indocyanine green angiography.
OBJECTIVE
To evaluate indocyanine green angiography (ICGA) and fluorescein angiography (FA) in imaging and quantifying corneal neovascularization (CNV).


METHODS
Patients with CNV were studied using a standardized protocol of color digital photography, FA, and ICGA. Images were graded independently by two observers and assessed for quality, phases of fluorescence, and leakage. Areas of CNV and vasculature geometric properties were analyzed and quantified by an automated program.


RESULTS
Twenty-three patients with good quality images were included. Mean times to appearance of ICG and fluorescein were 17 and 20 seconds (P = 0.10). Best images for analysis were obtained at 64 seconds for ICGA and 47 seconds for FA. CNV not apparent on color or FA, particularly in the presence of scarring, was well delineated by ICGA. Leakage of ICGA did not occur. Fluorescein leakage from apical CNV images occurred significantly earlier (32 seconds) in patients with CNV of <6-month duration than those of >1-year (50 seconds) duration (P = 0.04). Mean area of CNV and vessel diameter were similar with ICGA (8.79 mm(2), 0.058 mm) or FA (7.74 mm(2), 0.054 mm) but significantly larger than on color (1.94 mm(2), 0.026 mm) images (P < 0.01). Vessel tortuosity was similar on ICGA (1.16), FA (1.17), and color (1.15) (P = 0.27).


CONCLUSIONS
Combined use of FA and ICGA are valuable tools with which to assess CNV and provide better vessel delineation than can be obtained with only color images. Parameters used to assess CNV, such as leakage, area, diameter, and tortuosity, may be useful measures for evaluating treatment. Videography is useful for detecting early leakage.
Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom. danijeet@hotmail.com
Deepa R
DR
Anijeet
Yalin
Y
Zheng
Adrian
A
Tey
Martin
M
Hodson
Henri
H
Sueke
Stephen B
SB
Kaye
D000328:Adult; D000368:Aged; D004396:Coloring Agents; D003287:Contrast Media; D016510:Corneal Neovascularization / Q000175:diagnosis*; D005260:Female; D019793:Fluorescein; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D004396:Coloring Agents; D003287:Contrast Media; D007208:Indocyanine Green; D019793:Fluorescein