Indocyanine Green (ICG) Angiography at Retina Consultants
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Who Benefits from ICG Angiography
Our retina specialists at Retina Consultants recommend ICG angiography for patients whose eye conditions cannot be fully understood with regular eye exams or standard imaging tests. This test is especially valuable for complex cases that need detailed blood vessel assessment of the deeper choroidal layers.
If you have wet macular degeneration, ICG can be most helpful when occult choroidal neovascularization is suspected or when polypoidal choroidal vasculopathy or pachychoroid features are being considered. Findings can refine diagnosis and sometimes influence treatment choices and follow-up plans alongside OCT and, when needed, fluorescein angiography.
For patients with central serous chorioretinopathy, ICG helps our specialists locate exactly where fluid is leaking beneath your retina. ICG highlights choroidal hyperpermeability and leakage patterns to support diagnosis and to help target therapies such as half-dose or half-fluence photodynamic treatment when appropriate. The test also shows us problems with the choroid layer that may be causing your condition, helping us choose the most effective treatment for your specific case.
This condition involves abnormal blood vessel growths that look like small balloons in the choroid. Indocyanine green angiography remains the reference standard for delineating the branching vascular network and polypoidal lesions, complementing OCT and OCTA. It helps our doctors plan targeted treatments like photodynamic therapy or anti-VEGF therapy.
Our retina specialists use ICG angiography to evaluate many other serious eye conditions.
- ICG is occasionally used for certain choroidal tumors (for example, circumscribed choroidal hemangioma), but melanoma evaluation relies more on clinical exam, ultrasound, OCT, and fluorescein angiography
- Inflammatory diseases affecting the choroid and retina
- Hidden choroidal neovascularization that other tests cannot detect
- Unusual macular lesions that require specialized evaluation
- Blood vessel problems related to high myopia
- Complications from other eye diseases or surgeries
- Unexplained vision changes when standard imaging is inconclusive
Our fellowship-trained retina specialists also use ICG angiography to diagnose rare eye diseases in children and inherited retinal conditions that affect the choroidal blood vessels. In children, ICG angiography is off-label but may be used when medically necessary; dosing is weight-adjusted and precautions are taken to make the experience comfortable and safe for our younger patients and their families.
What to Expect During Your Visit
ICG angiography at Retina Consultants is performed in our comfortable, state-of-the-art imaging suites at our Ridgewood, Belleville, and Jersey City locations. We prioritize your safety, comfort, and understanding throughout the entire process.
You do not need to fast or avoid eating before your ICG angiography. Please tell our staff about any prior reactions to indocyanine green or iodinated agents, any medical conditions, medications you take, or if you are pregnant or breastfeeding. Also inform us of any planned radioactive iodine thyroid testing so timing and precautions can be optimized. This information helps us take proper precautions and ensure your safety.
Here's exactly what happens during your ICG angiography.
- Our skilled technician will place a small IV line in your arm for the dye injection
- You will sit comfortably in front of our advanced imaging camera
- After the IV is placed, the dye is injected and a sequence of images is taken as the dye circulates through the eye's vessels
- Early frames capture the first seconds of choroidal filling
- Mid-phase images follow to about 10 minutes
- Late-phase images often extend to 10–20 minutes, and occasionally up to about 30 minutes, for complete assessment
- You may need to look in different directions as instructed
- The entire scanning process typically takes 15 to 30 minutes
Most patients find the test comfortable and easy to tolerate. The test involves a brief IV placement for dye injection and a sequence of photographs while you sit normally during imaging. You may feel a brief pinch when we place the IV line in your arm, and some people notice a cool sensation, mild metallic taste in their mouth, or brief nausea during or right after the dye injection, but these feelings go away quickly. ICG is rapidly protein-bound and cleared by the liver into bile; visible discoloration of urine or skin is not expected.
ICG angiography requires no downtime or recovery period. You can return to your normal daily activities right after the test is finished. Images are reviewed by our experienced retina specialists who will carefully analyze your results and explain the findings during your follow-up appointment. We will discuss any recommended treatments or next steps in your care plan in clear, understandable terms. The test itself does not affect vision, but dilation drops used may cause temporary blurring, so bring sunglasses and check with our staff before driving.
Frequently Asked Questions
Here are answers to the most common questions our patients ask about ICG angiography at Retina Consultants.
Yes, the ICG dye is FDA-approved for ophthalmic angiography in adults and is considered very safe for most patients. It is generally well tolerated, with uncommon adverse reactions and rare hypersensitivity events. Our staff carefully monitors you during the entire test and is trained to handle any problems that might occur. ICG is rapidly protein-bound and cleared by the liver into bile rather than by the kidneys.
Individuals with a known hypersensitivity to indocyanine green or iodide should not receive ICG angiography. Because the formulation contains up to 5% sodium iodide, this is an important contraindication to discuss with our team. A history of “iodine” or shellfish allergy alone is not a reliable predictor of ICG reaction, and we review specific reaction history to proceed safely.
The procedure is not painful. You may feel a brief pinch when we place the IV line in your arm, but most patients feel no discomfort during the actual imaging. The test involves a brief IV placement for dye injection and a sequence of photographs while you sit normally. Some people notice a cool sensation or metallic taste when the dye is injected, but this passes quickly. Most people find it comfortable and can sit normally during imaging.
The entire procedure typically takes 15 to 30 minutes. Imaging captures early, mid, and late phases, with late frames commonly obtained up to 10–20 minutes after injection and occasionally extended to about 30 minutes to fully evaluate the choroidal circulation.
Most people have no side effects from ICG angiography. The most common mild effects include a metallic taste or brief nausea. Mild reactions can include nausea or hives, while rare severe hypersensitivity reactions have been reported. Our team monitors closely during the procedure and is fully prepared to treat any reaction immediately. Please contact our office immediately if you experience any unusual symptoms after your test, such as severe nausea, difficulty breathing, unusual skin reactions, or any other concerning symptoms.
The test itself does not affect your vision or ability to drive safely. However, dilation drops used may cause temporary blurring, so bring sunglasses and check with our staff before driving. If you receive other treatments or procedures during your visit that might affect your vision, we will let you know if you need someone to drive you home.
ICG angiography may be used in children when medically necessary as an off-label use. Our retina specialists can perform ICG angiography on children when it is medically appropriate. We take special care to make the experience as comfortable as possible for young patients and their families. The dye dosage is adjusted appropriately for children's smaller body size.
Please inform our team if you are pregnant or breastfeeding so we can discuss timing and safety considerations. In breastfeeding, interruption is generally unnecessary given rapid hepatic clearance and high protein binding, though we can discuss timing if you prefer added caution. In pregnancy, we consider ICG when the expected diagnostic benefit is important and alternatives are insufficient.
Schedule Your ICG Angiography Today
When our retina specialists recommend ICG angiography, you can trust Retina Consultants to provide expert care with advanced technology and a patient-focused approach at our convenient New Jersey locations serving the entire tri-state area.