30. Choroidal Hemangioma

Medical History

A 56-year-old female patient with vision loss in the right eye for 3 years was examined in our clinic. 

Diabetes mellitus (-)
Systemic hypertension (+)
Family history (-)
Smoking (-)
Trauma(-)

Examination Findings

Best corrected visual acuity was 1/10 in the right eye and 9/10 in the left eye. Intraocular pressure was 9 mmHg in the right eye and 10 mmHg in the left eye. Anterior segment examination revealed nuclear sclerosis in both eyes. Fundus examination revealed elevation at the posterior pole in the right eye. (Figure 1).

Figure 1

Fundus autofluorescence imaging shows hypoautofluorescence at the posterior pole in the right eye (Figure 2).

Figure 2

SD-OCT imaging shows choroidal lesion, subretinal and intraretinal fluid in the right eye (Figure 3).

Figure 3

Fluorescein angiography (FA) demonstrates hyperfluorescence at the posterior pole (Figure 4) and indocyanine green angiography shows a late hypofluorescence in the right eye (Figure 5).

Figure 3A
Figure 3B

Differential Diagnosis

Choroidal nevus, metastasis

Diagnosis

Choroidal Hemangioma

Choroidal hemangioma is a benign hamartoma. It appears as two different clinical pictures. Circumscribed choroid hemangioma is an isolated lesion without systemic symptoms. Diffuse choroidal hemangioma coexists with Sturge-Weber syndrome. In circumscribed choroid hemangioma, in case of presence of fluid which threatens vision, treatment is considered.

Treatment

Full dose photodynamic therapy

References

Sayman Muslubas I, Arf S, Hocaoglu M, Ozdemir H, Karacorlu M. SPONTANEOUS
REGRESSION OF SEROUS RETINAL DETACHMENT ASSOCIATED WITH
CIRCUMSCRIBED CHOROIDAL HEMANGIOMA AFTER CHILDBIRTH. Retin Cases Brief
Rep. 2017;11(1):7-11.https://pubmed.ncbi.nlm.nih.gov/26807496/

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