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Safety of Indocyanine Green Angiography During Pregnancy
A Survey of the Retina, Macula, and Vitreous Societies
Mitchell S. Fineman, MD;
Joseph I. Maguire, MD;
Steven W. Fineman, MD;
William E. Benson, MD
Arch Ophthalmol. 2001;119:353-355.
Objectives To establish current practice patterns and assess the general knowledge
among vitreoretinal-trained physicians regarding the use of indocyanine green
(ICG) angiography during pregnancy, and to review the literature regarding
the established safety of ICG angiography in pregnant women.
Methods A survey was mailed to 1101 members of the Retina, Macula, and Vitreous
Societies.
Results Of the 520 respondents, 434 (83%) had seen at least 1 pregnant woman
who required ICG angiography or fluorescein angiography. Of these, 385 (89%)
withheld fluorescein angiography and 105 (24%) withheld ICG angiography, largely
because of fear of teratogenicity or lawsuit. Diabetic retinopathy and choroidal
neovascular membrane were the most common indications for fluorescein angiography,
and choroidal neovascular membrane and choroidal tumor were the most common
indications for ICG angiography. Only 24% thought that it was safe to use
ICG angiography in a pregnant patient, and only 5% thought it was safer than
fluorescein angiography.
Conclusions Despite the documented safety of ICG when used for retinal angiography
and the extensive experience with the use of intravenous ICG to measure hepatic
blood flow in pregnant women, the results of this survey suggest widespread
hesitation to use ICG for retinal angiography in pregnant women. Current practice
patterns regarding the use of ICG angiography in pregnant patients may be
unnecessarily restrictive.
From Retina Vitreous Consultants, Pittsburgh, Pa (Dr M. Fineman); Retina
Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University,
Philadelphia, Pa (Drs Maguire and Benson); and Beth Israel Deaconess Medical
Center, Harvard Medical School, Boston, Mass (Dr S. Fineman).
RELATED ARTICLE
Archives of Ophthalmology Reader's Choice: Continuing Medical Education
Arch Ophthalmol. 2001;119(3):464.
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