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In the September 1993 issue of the Archives, Yoneya and Noyori1 reported that visualization of the choroidal circulation of Japanese monkeys in indocyanine green (ICG) angiograms was improved by binding ICG with autologous serum before injecting it, and they suggested that this method be used in human patients. Before recommending human use of such a technique, however, the potential benefits of that technique must be carefully weighed against its costs in terms of added difficulty and risk to both patient and angiographer. In this case, a significant benefit has not been convincingly demonstrated, making the additional costs in procedure time and risks associated with blood handling and preparation seem unwarranted.
Yoneya and Noyori determined that in vitro equilibrium between ICG dye and a volume of serum albumin required 10 minutes, and since it is well known that fluorescence of protein-bound ICG is considerably greater than that of ICG in
Flower RW. Does Preinjection Binding of Indocyanine Green to Serum Actually Improve Angiograms?. Arch Ophthalmol. 1994;112(9):1137-1138. doi:10.1001/archopht.1994.01090210021003