Indocyanine green enhanced transpupillary thermotherapy of circumscribed choroidal haemangioma

Abstract

Purpose. To investigate the effect of indocyanine green in enhancing the effect of diode laser for treatment of circumscribed choroidal haemangioma. Methods. Intravenous indocyanine green was used to enhance uptake of heat energy during transpupillary diode thermotherapy of circumscribed choroidal haemangioma. Results. In a series of 6 patients treated in this manner, response to treatment was much improved compared with results without the use of indocyanine green. All patients retained the same or better visual acuity after treatment, and 67% of eyes improved visual acuity by more than 2 lines on Snellen testing. Ultrasonographic and angiographic evidence of improvement was seen in all patients. Treatment complications were minimal, comprising transient worsening of pre-existing cystoid macular oedema in one case, and a small macular branch vein occlusion in the retina overlying the treated area. Conclusions. The use of indocyanine green as a contrast medium during transpupillary thermotherapy allows consistent uptake of diode laser energy, and shortens the duration of laser burn required. It is a cost-effective, easily performed outpatient procedure, with lower morbidity than other treatment modalities.