Indocyanine green angiography of circumscribed choroidal hemangiomas

Indocyanine green (ICG) angiography performed with the modern high resolution digital system already has improved our knowledge of several chorioretinal disorders. It could provide new information on circumscribed choroidal hemangiomas.

Twelve consecutive patients with circumscribed choroidal hemangioma underwent both fluorescein angiography and ICG angiography with a digital high resolution system. In each patient, two ICG angiograms were taken - with normal and with artificially increased intraocular pressure. The latter method allowed analysis of the vascular connections of the tumor with the adjacent choroid during the induced slowdown of blood flow.

With ICG, the authors obtained a clear delineation of the choroidal hemangiomas. In all cases, the lesion was better defined on the ICG than on the fluorescein angiogram. Nutrient and draining vessels of the tumors were identified. Nutrient vessels were represented by short posterior ciliary arteries in five eyes with severe exudative syndrome, and by ramifications of choroidal arteries in the other cases. Further special ICG findings were apparent choroidal ischemia downstream from the tumor (9 eyes), and clearing of the dye with a "washout" phenomenon.

Indocyanine green angiography can be helpful in the clinical evaluation of circumscribed choroidal hemangiomas. The blood supply to these tumors is provided directly by short posterior ciliary arteries or by ramifications of choroidal arteries. An adjacent compromised choroidal perfusion may be present.