INDOCYANINE GREEN ANGIOGRAPHY OF CHOROIDAL TUMORS

Background: Fluorescein angiography (FA) has been widely used in the d iagnostic evaluation of choroidal tumors. Indocyanine green angiograph y (ICG-A), which permits better visualization of choroidal vasculature than FA, has been recently introduced into clinical practice. Only fe w reports exist on the ICG-A characteristics of choroidal tumors. Meth ods: The fluorescein and indocyanine green angiograms of 61 patients w ere assessed. These included 14 patients with choroidal nevi, 30 with malignant melanomas, 7 with suspected melanomas or atypical nevi, 5 wi th hemangiomas and 5 with metastases. Results: The outline of pigmente d tumors was more accurate on ICG-A than on FA. Characteristic pattern s were seen in all intra-ocular tumors with ICG-A, so it was possible to distinguish hemangiomas from malignant lesions. Characteristic feat ures of malignant melanomas include abnormal vascular pattern and marg inal late dye leakage. None of the benign lesions showed these feature s. In suspected melanomas, the presence of abnormal choroidal vascular patterns and/or late dye leakage on ICG-A may indicate malignancy. Co nclusion: The study suggests that ICG-A can yield additional informati on that is useful in differentiating amongst choroidal tumors. Better delineation of pigmented lesions with ICG-A allows more accurate treat ment planning and follow-up.