[Simultaneous fluorescein and indocyanine green angiography with a confocal laser ophthalmoscope]

We report on our clinical experience with a recently developed confocal scanning laser ophthalmoscope for simultaneous fluorescein and indocyanine-green (ICG) angiography.

Following injection of fluorescein and ICG mixed in one syringe simultaneous confocal scanning laser fluorescein and ICG angiography were carried out using the Heidelberg Retina Angiograph (HRA). An argon laser (488 nm) and a diode laser beam (795 nm) from an external source were delivered via single-mode fibers. Emission was recorded between 500 and 650 nm and above 810 nm, respectively. Digital images were displayed simultaneously on a monitor during angiography.

A total of 295 simultaneous angiograms in 268 patients with various retinal and choroidal diseases, including exudative age-related macular degeneration with occult and classic choroidal neovascularization, were obtained. High-contrast images during all phases of the angiography were obtained. Besides mild side effects in similar frequency known from individual injections, no additional toxic or allergic reactions from simultaneous injections of the two dyes were observed.

Confocal laser scanning angiography allows for simultaneous fluorescein and ICG angiography. Compared with consecutive investigations using both dyes, simultaneous angiography requires only one injection, and offers identical digital frames. Simultaneous injection is not associated with additional side effects.