Retinal capillary hemangioma treatment by indocyanine green-mediated photothrombosis.
OBJECTIVE
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.
Costa
Rogério A
RA
Instituto da Visão-IPEPO, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. roger.retina@globo.com
Meirelles
Rodrigo L
RL
Cardillo
José A
JA
Abrantes
Marcelo L
ML
Farah
Michel E
ME
D000293:Adolescent; D004396:Coloring Agents / Q000627:therapeutic use*; D005451:Fluorescein Angiography; D018324:Hemangioma, Capillary / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007208:Indocyanine Green / Q000627:therapeutic use*; D007368:Interferometry; D008027:Light; D008297:Male; D010778:Photochemotherapy; D011446:Prospective Studies; D019572:Retinal Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D012171:Retinal Vessels / Q000187:drug effects* / Q000473:pathology; D013927:Thrombosis / Q000209:etiology; D014054:Tomography; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green