Anaphylactic Shock Following Indocyanine Green Angiography

The use of indocyanine green (ICG) dye by ophthalmologists is increasing as studies demonstrate its utility in the diagnosis and management of conditions affecting the choroidal vasculature. In the ophthalmic literature, there have been four reported cases of severe hypotensive reactions, all of which were successfully treated.1-3Wolf et al1reported a case of anaphylactic reaction following ICG administration in which the patient became hypotensive with "labored breathing with wheezing." In a subsequent review of 1226 consecutive patients receiving ICG dye, one severe reaction (0.05%) was reported.2In a recent survey of Japanese ophthalmologists, 2820 patients received ICG angiograms, with two severe reactions reported.3While hypotensive anaphylactic shock has been previously reported, the following case represents the most severe reaction reported thus far in the ophthalmic literature. Report of a Case. On July 13,1995, an 87-year-old white man was scheduled for ICG videoangiography for evaluation of