Infrared imaging of circumscribed choroidal hemangiomas

Purpose: To describe the features of choroidal tumors on infrared (IR) imaging and to determine the diagnostic sensitivity and specificity of intratumoral choroidal vascular loops on IR imaging for circumscribed choroidal hemangioma (CCH). Methods: Infrared and indocyanine green images of CCH, choroidal metastases, and choroidal melanomas were reviewed. The main outcome measure was the presence of intratumoral choroidal vascular loops and tufts on IR images. The secondary outcome measure was the presence of peritumoral vascular expansion on indocyanine green images. Results: Intratumoral CCH vessels appear as dark beaded spaces on IR imaging; 95.5% of CCH had vascular loops compared with the controls of 65% in choroidal melanomas and 64% in choroidal metastases. The sensitivity of intratumoral vessels on IR for CCH was 95.4%. Subanalysis of six patients with CCH showed the presence of peritumoral vascular expansion on indocyanine green images. Conclusion: Infrared imaging delineates intratumoral vessels in choroidal tumors appearing as dark beaded loops and tufts. Vascular loops on IR imaging showed a high diagnostic sensitivity for CCH. The absence of these loops on IR can help rule out the diagnosis of CCH. Peritumoral vascular expansion on indocyanine green is an additional diagnostic tool that is helpful in the diagnosis of CCH.