“Indocyanine green enhanced TTT Vs TTT for treatment of thicker tumors in Retinoblastoma- a randomised control trial”

Transpupillary thermotherapy (TTT) is used as a focal treatment modality for smaller retinoblastoma tumors, however its efficacy in thicker tumors is limited. This study evaluated whether indocyanine green (ICG) augmentation of TTT (ICGeTTT) improves tumor regression compared to TTT alone for residual chemoreduced retinoblastomas >2 mm in height. In this randomized controlled trial, simple randomisation table was used to allocate 28 chemoreduced tumors to treatment with either TTT (group 1) or ICGeTTT (group 2). Treatment was administered every 3–4 weeks until tumor height was <2 mm or a maximum of four sessions were completed. The baseline tumor height was higher for the ICGeTTT group. Adjusted analysis for this baseline difference showed a statistically significant greater reduction in tumor height for group 2 (44 %) as compared to group 1 (21 %) ( p = 0.018). The percentage of tumors achieving complete regression was higher in group 2 but this difference did not reach statistical significance. The cumulative energy used and side effects from treatment were similar between the groups. Despite the limitations of the study including the small sample size and the baseline difference, the study still demonstrated a greater tumor height reduction with the use of ICGeTTT as compared to TTT in chemoreduced thick residual tumors and hence ICGeTTT may be preferred in such cases.