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Circumscribed choroidal hemangioma: characteristic features with indocyanine green videoangiography
J F Arevalo1, C L Shields, J A Shields
1Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Objective:
To determine the characteristic features of indocyanine green videoangiography (ICG-V) of circumscribed choroidal hemangioma.
Design:
Prospective, observational case series.
Participants:
Twenty-five eyes of 25 consecutive patients with circumscribed choroidal hemangioma.
Intervention:
Indocyanine green videoangiography and intravenous fluorescein angiography (IVFA) were prospectively performed and reviewed. The specific features on ICG-V were compared with features of IVFA.
Main Outcome Measures:
The behavior of circumscribed choroidal hemangioma cases was observed with ICG-V and IVFA.
Results:
On ICG-V, earliest hyperfluorescence of circumscribed choroidal hemangioma was achieved at a mean of 27.6 seconds (range, 13-62 seconds), whereas maximum hyperfluorescence occurred at 222 seconds (range, 33-707 seconds). In the late frames, all eyes demonstrated a relative decrease in fluorescence, including 18 eyes (72%) that demonstrated "washout" of the dye. Other findings on ICG-V included intrinsic vessels in 19 eyes (76%), a late hyperfluorescent rim in 19 eyes (76%), and late frame hot spots in 14 eyes (56%). On IVFA, the earliest hyperfluorescence was achieved at a mean of 24 seconds (range, 10-66 seconds), whereas maximum hyperfluorescence occurred at a mean of 76.3 seconds (range, 21-720 seconds). Increasing hyperfluorescence in the late frames was found in all cases. Other findings included intrinsic vessels in 12 eyes (48%) and hot spots in the late frames in 9 eyes (36%).
Conclusions:
Circumscribed choroidal hemangioma have specific characteristics on ICG-V that are not visualized with IVFA. We believe that ICG-V may become an important noninvasive tool for the diagnosis of choroidal hemangioma.