Group,
I will address the prevalence and application of ICGA in a later post, but
for now I would like to comment on the dosage issue:
- Whether imaging in single or simultaneous mode, the dye amount
should be calculated in milligrams (mg), rather than in cubic centimeters
(cc).
- ICG dye usually comes in powder form, as 25mg of dye
- A solvent is supplied, in many cases in a 10cc ampule of water
for injection, which is the recommended ratio of dye to diluent
- Some / many locations use less than the 10 cc diluent, resulting
in faster injection times and (much) more contrasty early-stage images
- There are 'arguments' for using the different concentrations
- When reporting / addressing the issue of 'dye dosage' used in
ICGA testing, I think it would make more sense to outline the mg amount used
in the test, possibly along with the amount of diluent used, if different
from the manufacturer's recommendation.
- Comments and reasons for using different amounts and
concentrations of the dye are germane to this discussion, I think.
My 2 cc worth,
Ethan
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of Paula Morris
Sent: Wednesday, January 30, 2019 1:14 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: ICG thoughts from Denice
At ICOP Singapore we heard from several retina specialists of note that ICG
is THE best way to correctly diagnose Polypoidal Degeneration. Several large
clinical trials for Polypoidal utilize ICG as an essential component. So in
The Asia Pacific region where there are the largest populations susceptible
to Polypoidal disease, ICG is still a significant imaging modality. I would
say the Uveitis specialists at Moran Eye Center use it more frequently than
others have reported on this thread
P
Sent from my iPhone
On Jan 29, 2019, at 3:13 PM, CPMC Ophthalmic Diagnostic Center
<dmarc-noreply@xxxxxxxxxxxxx <mailto:dmarc-noreply@xxxxxxxxxxxxx> > wrote:
We do maybe a dozen a year; generally for the Uveitis clinic. PCV,
Chorioretinitis. Not that common.
Hospital setting would have kittens going off label and refrigerating dose
to keep it. Private practices only can get away with that.
I was at the RHEM meeting last week. Steve Charles, MD, Mr. Retina,
publically stated that he hardly ever orders FA anymore and that "not
necessary to have an imager do it". Thanks Steve.
WHEN we do ICG, we do a combo FA/ICG using the 2cc added to the 2cc FA and
Spectralis. Works great.
You cannot bill separately for the contrast media under any circumstance; it
is bundled into the procedure itself. Sutter tried their darndest to get
around that rule without success. Nice to have on site, on payroll billing
and coding experts at your disposal, thus I can speak with some authority
here. Believe me, if you could do it, Sutter would find a way.
4 ICG patients within a 36 hour period would be stretching it statistically;
the applications are not % found that widely in the human condition. Must
be a VERY busy retinal practice.
Denice Barsness, CRA, COMT, CDOS, FOPS
CPMC Dept of Ophthalmology/ The Eye Institute
Ophthalmic Diagnostic Services
711 Van Ness Avenue Suite 250
San Francisco CA 94109
415-600-5781
FAX 415-558-7011
