Special report: Noninvasive multi-parameter functional optical imaging of the eye.

Advancement in the treatment of blindness depends on the development of new technologies that enable early detection, follow-up, and treatment of disease. The authors describe direct, noninvasive imaging of four parameters: blood flow, blood oximetry, metabolic state, and hidden vasculature, particularly capillaries. These are functional parameters of the retina known to be degraded by retinal disease.

ICGA-guided laser photocoagulation of feeder vessels of choroidal neovascular membranes in age-related macular degeneration. Indocyanine green angiography.

Purpose: To report the ability of indocyanine green angiography (ICGA) with a confocal scanning laser ophthalmoscope (SLO) to identify feeder vessels of choroidal neovascular membranes (CNVM) secondary to age-related macular degeneration (ARMD) and to show the feasibility of inducing complete closure of the CNVM by photocoagulation targeted exclusively to the feeder vessels.

Methods: Five consecutive patients with exudative ARMD in whom ICGA with the confocal SLO showed extrafoveal feeder vessels supplying choroidal neovascular nets had laser photocoagulation done only to the feeder vessels. In two patients, two separate membranes were seen.

Confocal tomographic angiography of the optic nerve head in patients with glaucoma.

Purpose: To demonstrate the superficial and deep blood supply of the optic nerve using a new method, confocal tomographic angiography, which combines two new techniques, confocal laser scanning ophthalmoscopy and indocyanine green angiography, into one system.

Methods: In a prospective study using confocal tomographic angiography, we evaluated the correlation between the vascular supply of the optic nerve and that of the visual field in 90 eyes of 49 subjects (25 eyes of 20 subjects with normal visual field and 65 glaucomatous eyes of 39 subjects with visual field defects; 10 subjects each had one eye with normal visual field and one with visual field defects).

Results: In 22 of 25 eyes with a normal visual field, a diffuse microvascular filling pattern of the optic disk area was apparent with no filling defects.

Ocular blood flow velocity in age-related macular degeneration.

Background: Changes in the structure of the ocular blood vessels associated with age-related macular degeneration (AMD) have been described in some detail, but comparatively little is known of the concomitant circulatory changes. The goal of this study is to evaluate changes in the ocular circulation that may be associated with AMD.

Methods: Ocular blood flow velocities and vessel pulsatilities were measured in volunteers with and without AMD using a color Doppler imaging unit.

Adverse reactions due to indocyanine green.

Background: Although adverse reactions to indocyanine green (ICG) are known to occur, the dye has been used for more than 30 years in tests of cardiac and hepatic function, with a high level of safety. Improved digital video technology has renewed interest in the use of intravenous ICG in ophthalmic imaging. This report describes the authors' experience regarding the safety of ICG for digital angiography and their recommendations for its use in the ophthalmic setting.