Abstract
Purpose::
To describe the clinical and angiographic findings in two patients with retinal capillary hemangioma (RCH) and macular exudative complications treated with indocyanine green (ICG)-mediated photothrombosis.
Methods::
In the setting of a tertiary referral center, two patients with large RCH complicated with exudative retinal detachment involving the macula were treated with an alternative laser-dye procedure consisting of intravenous high-dose ICG injection and subsequent large spot, low-irradiance 810-nm laser application. Changes in clinical and fluorescein angiography findings from baseline were prospectively evaluated.
Results::
Marked reduction of the RCH with complete resolution of exudative retinal detachment after treatment was observed by clinical examination in both patients. Fluorescein angiography demonstrated hypoperfusion of the RCH and marked narrowing of the lesion feeder and draining vessels as early as four weeks after ICG-mediated photothrombosis in both patients. At last follow-up, neither clinical nor angiographic signals of tumor activity were observed, and best-corrected visual acuity had improved from 20/200 to 20/30 in one patient 2 years after treatment, and remained stable at 20/400 in the other 8 months after the procedure, probably due to complications of chronic macular detachment in the latter. Minimal laser-induced effects were noted in the vicinity of the tumor in both patients.
Conclusions::
ICG-mediated photothrombosis treatment resulted in complete restoration of the macular architecture in both patients with large peripheral RCH by means of direct occlusion of the tumor vasculature and rapid resolution of subretinal fluid.
Keywords: tumors • retina • retinal detachment