Choroidal vasculopathy detected by indocyanine green angiography in diabetic patients

Purpose
The aim of the study was to evaluate choroidal circulation in the posterior pole of the eye in diabetic patients with nonproliferative retinopathy.

Material and methods
Angiographic evaluation of choroids in the posterior pole were performed in diabetic patients with clinically detectable diabetic retinal changes in the Department of Ophthalmology, Medical Center of Postgraduate Education in Warsaw from December 2002 to December 2004, using HRA-system (Heidelberg Engineering, Germany). HRA-system allows to perform simultaneous fluoresceine (FA) and indocyanine green (ICGA) angiography.

Results
Simultaneous ICGA and fluorescein angiography pictures were evaluated. Choroidal abnormalities were defined as ICGA findings not detectable by FA. In ICGA we observed hypo- and hyperfluorescent areas or spots in different phases of the examination which proved break-down of outer blood-retinal barrier, retinal pigment epithelial oedema, increased permeability of choriocapillaries and chorioidal microaneurysms.

Conclusions
1. FA discloses only a part of vascular pathology in posterior pole of the eye in the course of diabetes. 2. ICGA may be useful as adjunctive to FA in the evaluation of the choroidal vascular changes in diabetic eyes. 3. Choroidal vessels changes may play role in the development of diabetic retinopathy.