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We\u2019ve put together some commonly asked questions about Diagnostic Green’s Indocyanine Green for Injection, USP (ICG), Indocyanine Green Injection for USP, known as Verdye in a number of European territories (ICG) is a tricarbocyanine dye with both hydrophilic and lipophilic properties. The retention of ICG in the fenestrated choroidal circulation, combined with its low permeability, makes ICG angiography ideal for viewing the choroidal blood vessels. Once injected, ICG binds to plasma proteins and quickly circulates to the choroid layer, delineating the choroidal veins within 15-20 secs.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t ICG is cleared exclusively through the liver and then excreted through the bile. It does not undergo metabolism. It has an excellent safety profile and adverse reactions occur very rarely (<1\/10,000).<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t ICG for Ophthalmic Retinal Angiogram was introduced in 1973. Since then, ICG for ophthalmic retinal angiogram can be used to investigate Retinal disorders including Macular\/Choroidal\/Outer Retinal Disorders.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t Indocyanine Green Angiography (ICGA) is the gold standard in diagnosing a number of serious eye conditions and is a key diagnostic tool used by ophthalmology specialists worldwide.<\/p> ICGA is particularly useful in the differential diagnosis of<\/p> Videoangiogram recordings via Scanning Laser Ophthalmoscopy allow for rapid identification of high contrast images. 25mg\/10ml Sterile Water dilution. 5ml bolus intravenous injection.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t Early Phase: 60 Seconds \u2013 Choroidal Leakage\/Irregular Choroidal Capillaries \/ Choroidal filling defect<\/p> Mid Phase: 1-3 Minutes<\/p> Late Phase: 15-45 Minutes \u2013 Hyper\/Hypo Fluorescent spots \u2013 Cannot be detected with other Fluorescein angiography.<\/p> Product Information Leaflet Indocyanine Green for Injection, USP Package Insert.<\/a><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t Applications where ICGA is considered superior include<\/p>\n There are a number of reasons including:<\/p> FA images Retinal Circulation whereas ICG images Choroidal circulation. These occur at different layers of the Retina.<\/p> FA is a low molecular weight molecule, and binds at an 80% level to plasma protein. ICG on the other hand has high molecular weight and binds to protein at 98%.<\/p> Light Emission: FA: Visible Spectrum, ICG: Infrared Spectrum.<\/p> FA – Observed via Blue\/Green Filter, ICG: Infrared Filter<\/p> \u00a0\u00a0<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t Technology for Retinal Imaging has continued to develop, including Ocular Coherence Technology (OCT).<\/p> Advantages and disadvantages in comparison to ICGA.<\/p> ICGA<\/p><\/td> OCTA<\/p><\/td><\/tr> ICGA fluorescence can penetrate blood, fluid and retinal pigment epithelium to reveal underlying abnormalities of the inner choroidal vasculature and is essential for making a definitive diagnosis of PCV.<\/p><\/td> Extremely motion sensitive, requiring a\u00a0patient to fixate on precise point for several seconds. Patient compliance required, which is often difficult, particularly for older patients.<\/p><\/td><\/tr> Excellent visualization within minutes, of the medium & large choroidal vessels.<\/p><\/td> OCTA takes more time than structural scans and requires trade-offs in flow resolution, scan quality and speed.<\/p><\/td><\/tr> ICGA is beneficial\u00a0in the differential diagnosis of PCV, Chronic CSC, and RAP.<\/p><\/td> Limited field of view leading to a greater likelihood that lesions may be missed.<\/p><\/td><\/tr> ICGA has been shown to optimize detection of capillary macro aneurysms in longstanding diabetic macular edema (DME) or retinal vein occlusion (RVO).<\/p><\/td> Failure to recognize OCTA Projection Artifact (blood vessels seem at erroneous location), may lead to inaccurate clinical assessment.<\/p><\/td><\/tr> A recent study demonstrated that late leakage in ICGA occurred in all RAP cases<\/p><\/td> Image processing for OCTA can alter blood vessel appearance through segmentation defects, and image display software can lead to false impressions of vessel location and density<\/p><\/td><\/tr> Duration of ICGA procedure only\u00a015-20mins, very quick analysis.<\/p><\/td> The analysis of these images is time-consuming – may involve many hours of post hoc manual segmentation work, which may be difficult to accommodate during daily medical work routines.<\/p><\/td><\/tr><\/tbody><\/table><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t To report suspected adverse reactions:
in the use for Ophthalmics.\u00a0
If you can\u2019t find the answer to your question, please <\/span>contact us<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
(Neovascular Choroidal Membranes).<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\n
contact us at 1-844-424-3784 or e-mail <\/span>drugsafety@diagnosticgreen.com<\/a><\/p>\n
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