The present role of indocyanine green angiography in ophthalmology

Recent developments in the clinical application of indocyanine green angiography have mainly concerned refining its role as an adjunct to fluorescein angiography in detecting and guiding the treatment of choroidal neovascularization. We now have a better understanding of the different patterns of abnormal hyperfluorescence seen with indocyanine green angiography in eyes with both wet and dry forms of macular degeneration. In exudative cases, the success rate of laser treatment guided by indocyanine green angiographic findings can vary considerably, and it is now known which angiographic presentations are not as likely to benefit. In dry macular degeneration, indocyanine green angiography appears to add clinically useful information, such as helping to identify plaques in fellow eyes with choroidal neovascularization or watershed zones that may be predictive of future exudative transformation. In certain circumstances, indocyanine green angiography can be valuable in detecting choroidal neovascularization in other macular diseases or in helping to diagnose other choroidal conditions, especially when the clinical presentation is atypical, such as central serous chorioretinopathy in elderly patients.