Choroidal haemangioma and its multimodal diagnosis: A case report

• Published in: Acta ophthalmologica (Oxford, England) England), 2022-12, Vol.100 (S275), p.n/a
• Main Authors: Rivasés, Guillermo Pérez, El Bakkali, Ismael Bakkali, De Rivas, Marta Orejudo, Arias, Pablo Cisneros, Moscarda, Eva Josefina Nuñez, Clavería, Julia Aramburu, Fernandez, Miguel Castillo, Martinez, Marta Suñer, Floria, Olivia Esteban, Puyuelo, Javier Ascaso
• Format: Article
• Language: English
• Subjects: Angiography; Case reports; Differential diagnosis; Eye; Fluorescein; Hemangioma; Inflammation; Lesions; Literature reviews; Medical imaging; Patients; Retina; Retinography; Tumors; Ultrasonic imaging; Ultrasound; Vascularization; Vision
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2022.0309

Purpose: To describe the clinical manifestations and diagnosis of choroidal haemangioma with the aid of different multimodal images, as well as its usefulness for making a differential diagnosis. Methods: A case of a patient who comes due to blurred vision is described, who underwent different complementary tests of multimodal images: optical coherence tomography (OCT), fluorescein angiography (FA), indocyanine green angiography (ICGA), autofluorescence (AF), ultrasound eye exam and retinography to achieve the accurate diagnosis. Results: We present the case of a 50‐year‐old patient who debuted with recently‐onset blurred vision in the left eye (LE). In the eye fundus of LE, a yellow‐orange temporal‐inferior lesion of 3 disc diameter (DD) with neurosensory detachment of 4 DD that affects the fovea is observed. An OCT is performed that shows a choroidal mass associated with subretinal and intraretinal fluid with hyperrefringent points, the B‐scan ultrasound shows a hyperechoic lesion in the posterior pole, and both ICGA and FA reveal a hyperfluorescent pattern in all its phases, being the choroidal vessels of better visualization in the latter phase (without double vascularization pattern). AF shows hyperautofluorescence. After the definitive diagnosis of choroidal haemangioma, he was referred for treatment with Argon laser with favourable results. Conclusions: Choroidal haemangioma is a rare benign vascular tumour that occurs in middle‐aged adults and can be circumscribed (CCH) or diffuse depending on its extension. For the diagnosis of intraocular tumours it is very important to make a good differential diagnosis with the help of multimodal images: OCT, FA, ICGA, AF, Ultrasound and retinography; in order to differentiate it from similar posterior pole lesions with worse prognosis. CCH itself is benign and asymptomatic, and its treatment consists of observation; but it can present inflammatory signs with subretinal fluid and affect the macular area and therefore a more invasive treatment is indicated. References. 1. Singh AD, Kaiser PK, Sears JE. Choroidal hemangioma. Ophthalmol Clin North Am. 2005;18(1):151–61, ix. 2. Berry M, Lucas LJH. Circumscribed choroidal hemangioma: A case report and literature review. J Optom. 2017;10(2):79–83.