Retinal capillary hemangioma treatment by indocyanine green-mediated photothrombosis

Am J Ophthalmol. 2003 Mar;135(3):395-8. doi: 10.1016/s0002-9394(02)01966-9.

Abstract

Purpose: To describe the clinical, angiographic and optical coherence tomography (OCT) findings of a patient with a large retinal capillary hemangioma who was treated by indocyanine green-mediated photothrombosis. Interventional case report.

Methods: An 18-year-old male patient was treated at a tertiary referral center with a novel laser-dye procedure that uses low-irradiance 810-nm laser and intravenous indocyanine green injection and was prospectively evaluated with fluorescein and indocyanine green angiography, as well as OCT.

Results: Vision improved from 20/125 to 20/32 + 1 at 1-year follow-up. Fundus photography showed marked reduction of a 3 disk diameters retinal capillary hemangioma. Both fluorescein and indocyanine green angiography demonstrated reduced tumor perfusion and narrowing of the lesion feeder and draining vessels as early as 5 days after indocyanine green-mediated photothrombosis; OCT showed immediate decrease in retinal elevation and complete resolution of subretinal fluid within 2 months of treatment. Minimal laser-induced effects were noted in the vicinity of the tumor.

Conclusions: Photothrombosis using low-intensity, 810-nm light to direct laser energy continuously at the tumor after intravenous indocyanine green infusion was effective in restoring macular architecture and improving vision in a patient with a large peripheral retinal capillary hemangioma by means of substantial occlusion of the tumor vasculature and resolution of subretinal fluid.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Coloring Agents / therapeutic use*
  • Fluorescein Angiography
  • Hemangioma, Capillary / blood supply
  • Hemangioma, Capillary / drug therapy*
  • Hemangioma, Capillary / pathology
  • Humans
  • Indocyanine Green / therapeutic use*
  • Interferometry
  • Light
  • Male
  • Photochemotherapy*
  • Prospective Studies
  • Retinal Neoplasms / blood supply
  • Retinal Neoplasms / drug therapy*
  • Retinal Neoplasms / pathology
  • Retinal Vessels / drug effects*
  • Retinal Vessels / pathology
  • Thrombosis / etiology
  • Tomography
  • Visual Acuity

Substances

  • Coloring Agents
  • Indocyanine Green