Circumscribed choroidal hemangioma: Comparison of fluorescein and indocyanine green video-angiography

Purpose. To compare fluorescein angiography (FA) to indocyanine green video-angiography (ICG-V) findings in circumscribed choroidal hemangiomas. The goal of the study was to determine if ICG-V is a useful adjunct in the diagnosis of circumscribed choroidal hemangiomas. Methods. Fluorescein angiography and ICG-V were prospectively performed in 25 consecutive patients (eyes) with circumscribed choroidal hemangiomas. Angiograms were reviewed independently by the authors in a masked fashion. A comparison between FA and ICG-V findings was made. Results. The earliest hyperfluorescence on FA was achieved 24 (range 10 to 66) seconds after injection while maximum hyperfluorescence was achieved 76.3 (range 21-720) seconds after injection. This hyperfluorescent pattern persisted throughout the study in all cases. Subretinal fluid was seen in 13 (52%) eyes, cystoid macular edema in 2 (8%) eyes, intrinsic vessels in 12 (48%) eyes, and hot spots in the late frames in 9 (36%) eyes. The earliest hyperfluorescence on ICG-V was achieved 27.6 (range 13 to 62) seconds after injection while maximum hyperfluorescence was achieved 222 (range 33-707) seconds after injection. In the late frames of the study all eyes presented a decrease of fluorescence including 18 (72%) eyes which demonstrated "washout" of the dye. A late hyperfluorescent rim was present in 19 (76%) eyes, intrinsic vessels in 19 (76%) eyes, a feeder vessel was seen in one (4%) eye, and hot spots in the late frames in 14 (56%) eyes. Conclusions. Indocyanine green video-angiography in circumscribed choroidal hemangiomas has very distinct characteristics that are not seen with other intraocular tumors. ICG-V may be a useful non invasive adjunct in the diagnosis of difficult cases.