Retinal capillary hemangioma treatment by indocyanine green-mediated photothrombosis

Abstract

PurposeTo 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. DesignInterventional case report. MethodsAn 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. ResultsVision 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. ConclusionsPhotothrombosis 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.