Angiographie au vert d'indocyanine dans les uvéites postérieures

BACKGROUND: Indocyanine-green (ICG) angiography gives additional information in posterior inflammatory conditions by enabling to analyse the choroid. It may become a useful work-up procedure in inflammatory diseases predominantly involving the choroid. Our purpose was to analyse ICG findings and correlate them to fluorescein angiographic and clinical findings in posterior uveitis. PATIENTS AND METHODS: In patients with posterior uveitis involving the choroid, ICG angiography is performed routinely in addition to the usual uveitis work-up. We report on the ICG angiography features found in sarcoidoses (6 cases), birdshot chorioretinopathy (4 cases), multiple evanescent white dot syndrome (MEWDS, 2 cases), Vogt-Koyanagi-Harada disease (2 cases) and multifocal choroiditis (2 cases). RESULTS: The hypofluorescent lesions characteristic for choroidal lesions were seen in all 5 analyzed entities. They corresponded either to active inflammatory lesions or to atrophic areas of the choroid. To distinguish between these 2 situations correlation between clinical findings, fluorescein angiography and ICG angiography was necessary. Except for multifocal choroidits where hypofluorescent areas corresponded essentially to atrophic areas, ICG angiography showed inflammatory choroidal lesions not seen clinically or by fluorescein angiography. ICG hyperfluorescence in the late phase of angiography seemed to be a sign for recent or acute inflammatory involvement. CONCLUSION: ICG angiography was helpful to assess choroidal involvement and disease progression in 4 of the posterior inflammatory disorders examined and will probably prove useful in the work-up of most posterior uveitis involving the choroid.