Artifactual reduction in oxygen saturation readings affected by indocyanine green in ophthalmic angiography
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CLINICAL INVESTIGATION
Artifactual reduction in oxygen saturation readings affected by indocyanine green in ophthalmic angiography Mitsuhiro Matsuzaki1,2 · Kanako Ishii1,2 · Akihiro Nishida1,2,3 · Naohiro Motozawa1,2 · Mizuho Fujimori1 · Mamiko Hamada1 · Yasuo Kurimoto1,2 Received: 17 September 2019 / Accepted: 9 April 2020 © Japanese Ophthalmological Society 2020
Abstract Purpose To investigate time-dependent changes in oxygen saturation (SpO2) readings during fluorescein angiography (FA) or simultaneous fluorescein and indocyanine green angiography (F/I). Study design A prospective observational study. Methods One hundred twenty-five consecutive patients underwent FA or F/I. After application of the exclusion criteria, 67 patients (28 underwent FA, 39 underwent F/I) were included in the study. During angiography, SpO2 was measured by using a pulse oximeter and recording each second. The arm-to-retina circulation time (ARCT) was measured on the angiography video images. Latency time was defined as the time from intravenous injection of the dye to observation of a 3% decrease in the SpO2 reading, and variation SpO2, as the difference between baseline SpO2 and the lowest SpO2 value. Results The mean variation S pO2 was − 1.0 ± 0.6 during FA, and − 6.1 ± 1.5 during F/I. Variation S pO2 was within 2% during FA and > 3% during F/I. No corresponding changes were observed in the other vital signs or subjective symptoms. The mean latency time was 33.3 ± 6.4 s. Latency time was positively correlated with the ARCT in the F/I group (rs = 0.766, P 3% in all cases in the F/I group. There was a maximum 9% reduction in the S pO2 readings in the F/I group (Fig. 5). A between-group comparison of SpO2 time courses is summarized in Table 2. The mean (± SD) SpO2 variation was − 1.0 ± 0.6 in the FA group and − 6.1 ± 1.5 in the F/I group. No significant between-group difference in SpO2 at 0 s was found, although the nadir S pO2 and S pO2 at 180 s were significantly lower in the F/I group than in the FA group. Latency and duration times were not measured in the FA group because all reductions in SpO2 were within 2%. The mean (± SD) latency and duration times in the F/I group were 33.3 ± 6.4 and 42.2 ± 28.6 s, respectively. The mean (± SD) ΔAUC was − 1.5 ± 79.0 in the FA group and − 312.5 ± 121.4 in the F/I group; the ΔAUC did not differ significantly from baseline in the FA group. The latency time was positively correlated with the ARCT in the F/I group (Spearman correlation coefficient, rs = 0.766; P
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