Indocyanine green angiographic findings in presumed intraocular tuberculosis
Marwan A Abouammoh1, Luca De Simone2, Abdullah N Almousa1
1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
Indocyanine green angiography (ICGA) is crucial for detecting subclinical tuberculous choroidal involvement, revealing hypofluorescent dark dots (HDDs) as the most common sign. This diagnostic tool aids in identifying ocular tuberculosis, even without apparent clinical symptoms.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Medical Imaging
Background:
- Intraocular tuberculosis presents diagnostic challenges, often with subtle or absent clinical signs of choroidal involvement.
- Indocyanine green angiography (ICGA) is an advanced imaging technique used to visualize choroidal vasculature and detect inflammatory processes.
Purpose of the Study:
- To investigate the characteristic features of Indocyanine green angiography (ICGA) in patients with suspected intraocular tuberculosis.
- To assess the utility of ICGA in identifying subclinical choroidal involvement in tuberculosis patients.
Main Methods:
- A retrospective analysis of 77 eyes from 48 patients who underwent ICGA for presumed intraocular tuberculosis.
- Evaluation of specific ICGA signs including choroidal perfusion inhomogeneity, hypofluorescent dark dots (HDDs), hypofluorescent geographic lesions (HGLs), and stromal vessel patterns.
Main Results:
- ICGA revealed subclinical choroidal involvement in 84.1% of eyes without prior clinical evidence.
- Hypofluorescent dark dots (HDDs) were the most prevalent finding (100% of affected eyes), followed by disc hyperfluorescence (45.5%) and fuzzy stromal vessels (38.6%).
- In eyes with clinical choroidal involvement, HDDs were present in 36.4%, HGLs in 30.3%, and disc hyperfluorescence in 33.3%.
Conclusions:
- Indocyanine green angiography (ICGA) is essential for diagnosing subclinical tuberculous choroidal involvement.
- Persistent hypofluorescent dark dots (HDDs) are the most frequent ICGA finding in ocular tuberculosis.
Purpose:
To study features of Indocyanine green angiography (ICGA) in patients with presumed intraocular tuberculosis.
Methods:
Retrospective study of 48 consecutive patients (77 eyes) who underwent ICGA. The following signs were analysed: choroidal perfusion inhomogeneity, early hyperfluorescent stromal vessels, round or oval hypofluorescent dark dots (HDDs), hypofluorescent geographic lesions (HGLs), fuzzy or lost pattern of large stromal choroidal vessels, disc hyperfluorescence and diffuse late choroidal hyperfluorescence.
Results:
Among 44 eyes of 29 patients with no clinical evidence of choroidal involvement, only 7 eyes of 6 patients had no ICGA evidence of choroidal involvement. On the other hand, ICGA findings suggesting choroidal involvement were noted in 37 (84.1%) eyes of 23 patients in the form of HDDs in all 37 (100%) eyes, HGLs in 7 (18.9%) eyes, disc hyperfluorescence in 20 (45.5%) eyes, fuzzy stromal vessels in 17 (38.6%) eyes, early hyperfluorescent stromal vessels in 13 (29.5%) eyes, late pinpoint hyperfluorescence in 11 (25%) eyes and late diffuse choroidal hyperfluorescence in 7 (15.9%) eyes. Among 33 eyes of 19 patients with clinically evident choroidal involvement, the following findings were identified; HDDs in 12 (36.4%) eyes, HGLs in 10 (30.3%) eyes, both HDDs and HGLs in 9 (27.3%) eyes, disc hyperfluorescence in 11 (33.3%) eyes, early hyperfluorescent stromal vessels in 7 (21.2%) eyes, fuzzy stromal vessels in 6 (18.2%) eyes and late diffuse choroidal hyperfluorescence was present in 2 (6.1%) eyes.
Conclusions:
ICGA is necessary in identifying and diagnosing subclinical tuberculous choroidal involvement. The most prevalent ICGA finding was persistent HDDs.
