Clinical trial · Observational
ICG Angiogram as a Predictor of Postoperative Visual Function After EEA Surgery
I See G: Superior Hypophyseal Artery Intraoperative Indocyanine Green Angiogram as a Predictor of Postoperative Visual Function After Endoscopic Endonasal Surgery
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Endonasal endoscopic approaches are an established treatment for suprasellar lesions compromising the optic nerves (ON). Surgery often involves dissecting tumors from the optic nerves and its blood supply, which can result in nerve damage and visual loss after surgery. To date, there are no reliable methods to monitor the optic nerve function during surgery and thus, post-surgical visual outcomes is unknown until the patients are fully awake after surgery for a visual exam. This delay in diagnosis prevents early therapeutic measures and can result in further harm to the ON. We have recently recognized that when ICG is routinely injected during these cases to check for patency of the big arteries the sub millimetric superior hypophyseal arteries supplying (SHA) the ON are also visible and that lack of visualization of these vessels is associated with worse visual deficits after surgery. Thus, ICG may be a tool to intraoperative predict visual outcomes after endonasal approach for suprasellar lesions and fill the nondiagnostic gap. This study will assess whether endoscopic ICG angiography before and after resection of suprasellar lesions can predict post-operative visual deficits. Successful completion will provide surgeons a novel tool to assess visual function during surgery. The ICG endoscopic angiograms suggested in this study are noninvasive and currently routinely performed at the end of surgery to check for patency of big brain arteries.
Conditions
Conditions (2)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Indocyanine Green | — | UNRESOLVED | — |
| Skull Base Neoplasms | Skull Base Neoplasm | ONTOLOGY_EXACT | 0.98 |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Indocyanine Green | Procedure | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- label
- ICG Group
- description
- Eligible participants are those diagnosed with suprasellar lesions undergoing ICG angiography during endoscopic endonasal resection.
- interventionNames
- Procedure: Indocyanine Green
Primary outcomes (1)
- measure
- Percentage of Patients with Post Operative Visual Acuity Impairment and Visual Field Defect
- timeFrame
- From the surgery to first post-operative follow up (6 weeks)
- description
- The investigators will evaluate the percentage of participants that present with decreased of visual acuity and any modality of visual field defect after the surgery. Postoperative visual acuity and visual field testing will be performed at 6 weeks postoperative follow up visit to evaluate chiasm function, including cranial nerve examination, bilateral number counting, letter reading, and number identification in 4 quadrants of peripheral vision. Visual evaluations will be performed by the ophthalmology service following our standard postoperative protocol.
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: * The study will enroll adult (18 y.o. and older) participants undergoing endonasal endoscopic surgery for suprasellar tumors including meningiomas, craniopharyngiomas and pituitary adenomas. Exclusion Criteria: * Underage patients (younger than 18 y.o).
References
Publications (4)
- BACKGROUNDOsorio RC, Aabedi AA, El-Sayed IH, Gurrola J 2nd, Goldschmidt E. Superior Hypophyseal Artery Intraoperative Indocyanine Green Angiogram as a Predictor of Postoperative Visual Function After Endoscopic Endonasal Surgery. Oper Neurosurg. 2023 Oct 1;25(4):379-385. doi: 10.1227/ons.0000000000000809. Epub 2023 Jun 27. PMID 37366631
- BACKGROUNDShahein M, Prevedello DM, Beaumont TL, Ismail K, Nouby R, Palettas M, Prevedello LM, Otto BA, Carrau RL. The role of indocyanine green fluorescence in endoscopic endonasal skull base surgery and its imaging correlations. J Neurosurg. 2020 Nov 13;135(3):923-933. doi: 10.3171/2020.6.JNS192775. Print 2021 Sep 1. PMID 33186906
- BACKGROUNDRamesh R, Gurrola JG 2nd, Goldschmidt E. Use of Real-Time Superior Hypophyseal Artery Indocyanine Green Angiogram During Endoscopic Resection of a Third Ventricular Craniopharyngioma: 2-Dimensional Operative Video. Oper Neurosurg. 2025 Jan 1;28(1):123-124. doi: 10.1227/ons.0000000000001225. Epub 2024 Jun 7. No abstract available. PMID 38847508
- BACKGROUNDLee MH, Lee TK. Application of fusion-fluorescence imaging using indocyanine green in endoscopic endonasal surgery. J Clin Neurosci. 2022 Apr;98:45-52. doi: 10.1016/j.jocn.2022.01.023. Epub 2022 Feb 4. PMID 35131724