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.

Methods: Digital ICG videoangiography was performed in 1226 consecutive patients, and 1923 ICG videoangiography tests were performed. A registry of adverse reactions to ICG was established. Criteria were used to define mild, moderate, and severe adverse reactions, and these data were recorded for every ICG study performed.

Results: There were three (0.15%) mild adverse reactions, four (0.2%) moderate reactions, and one (0.05%) severe adverse reaction. There were no deaths.

Conclusions: This study documents the safety of intravenous ICG for use in ophthalmic videoangiography.