Circumscribed choroidal hemangioma diagnosed by ultrasonography

Abstract

Circumscribed choroidal hemangioma (CCH), a relatively rare benign tumor, can cause differential diagnostic problems by its atypical appearance at the time of presentation. Ancillary test such as fluorescein angiography, indocyanin green angiography, ultrasonography, computer tomography (CT), magnetic resonance imaging (MRI) bring not always additional information and their results are not always pathognomic. We retrospectively reviewed the clinical records of 40 patients with the ultrasonographical diagnosis of CCH compiled in the last 20 years. Ultrasonography appeared to be uniform in its lesion characteristics and reliable in the diagnosis. During the mean follow-up time of 7.4 years there were no clinical or posttherapeutical developments that made a correction of the diagnosis necessary.

Bilateral circumscribed haemangioma of the choroid not associated with systemic vascular syndrome

“…During the mid-term follow up (15 months) there were neither ocular nor systemic significant modifications. The echographic9 and ICGA1-3 10 features of these choroidal lesions, together with the lack of neoplasm or vascular abnormality in another part of the body, lead us to confirm the first documented diagnosis of bilateral CCHs. Last but not least, our findings demonstrate that FA and echography are not always capable of documenting the specific characteristics of small CCH; thus, when this kind of lesion is suspected, ICGA represents the most important non-invasive tool for the diagnosis2 to differentiate amelanotic choroidal melanoma, choroidal metastasis, and choroidal haemangioma 10…”

Bilateral circumscribed haemangioma of the choroid not associated with systemic vascular syndrome

“…During the mid-term follow up (15 months) there were neither ocular nor systemic significant modifications. The echographic9 and ICGA1-3 10 features of these choroidal lesions, together with the lack of neoplasm or vascular abnormality in another part of the body, lead us to confirm the first documented diagnosis of bilateral CCHs. Last but not least, our findings demonstrate that FA and echography are not always capable of documenting the specific characteristics of small CCH; thus, when this kind of lesion is suspected, ICGA represents the most important non-invasive tool for the diagnosis2 to differentiate amelanotic choroidal melanoma, choroidal metastasis, and choroidal haemangioma 10…”

Circumscribed Choroidal Hemangioma Simulating Choroidal Melanoma on Advanced Ultrawide-Field Pseudocolor Retinal Imaging: A Case Series

“…[1][2][3][4][5][6][7][8] On ultrasonography, circumscribed choroidal hemangiomas have high internal refl ectivity on A-scan and are a solid, dome-shaped mass on B-scan. 2,16 Progressive hyperfl uorescence is seen on fl uorescein angiography with early hyperfl uorescence followed by late hypofl uorescence on indocyanine green angiography. 2,7 On enhanced depth imaging-optical coherence tomography (EDI-OCT), EDI-circumscribed choroidal hemangioma appears as a sloping choroidal mass with enlargement of medium-and large-sized choroidal vessels in the absence of choriocapillaris compression with intact Bruch's membrane complex.…”

“…Ancillary imaging of circumscribed choroidal hemangioma includes ultrasonography, fluorescein angiography, indocyanine green angiography, and optical coherence tomography 1–8. On ultrasonography, circumscribed choroidal hemangiomas have high internal reflectivity on A-scan and are a solid, dome-shaped mass on B-scan 2,16. Progressive hyper-fluorescence is seen on fluorescein angiography with early hyperfluorescence followed by late hypofluorescence on indocyanine green angiography 2,7.…”

Bilateral choroidal haemangioma in an otherwise normal middle aged female

“…A"washout" effect in the late phase is observed due to egress of dye from the hemangioma. 4 Circumscribed choroidal hemangioma is mainly asymptomatic hence only observation and follow up is required in most cases. Traditional treatment for CCH was xenon arc photocoagulation.it produced good resolution without residual scarring that can cause good visual recovery.…”

Bilateral circumscribed haemangioma of the choroid not associated with systemic vascular syndrome

“…During the mid-term follow up (15 months) there were neither ocular nor systemic significant modifications. The echographic9 and ICGA1-3 10 features of these choroidal lesions, together with the lack of neoplasm or vascular abnormality in another part of the body, lead us to confirm the first documented diagnosis of bilateral CCHs. Last but not least, our findings demonstrate that FA and echography are not always capable of documenting the specific characteristics of small CCH; thus, when this kind of lesion is suspected, ICGA represents the most important non-invasive tool for the diagnosis2 to differentiate amelanotic choroidal melanoma, choroidal metastasis, and choroidal haemangioma 10…”

Circumscribed Choroidal Hemangioma Simulating Choroidal Melanoma on Advanced Ultrawide-Field Pseudocolor Retinal Imaging: A Case Series

“…[1][2][3][4][5][6][7][8] On ultrasonography, circumscribed choroidal hemangiomas have high internal refl ectivity on A-scan and are a solid, dome-shaped mass on B-scan. 2,16 Progressive hyperfl uorescence is seen on fl uorescein angiography with early hyperfl uorescence followed by late hypofl uorescence on indocyanine green angiography. 2,7 On enhanced depth imaging-optical coherence tomography (EDI-OCT), EDI-circumscribed choroidal hemangioma appears as a sloping choroidal mass with enlargement of medium-and large-sized choroidal vessels in the absence of choriocapillaris compression with intact Bruch's membrane complex.…”

“…Ancillary imaging of circumscribed choroidal hemangioma includes ultrasonography, fluorescein angiography, indocyanine green angiography, and optical coherence tomography 1–8. On ultrasonography, circumscribed choroidal hemangiomas have high internal reflectivity on A-scan and are a solid, dome-shaped mass on B-scan 2,16. Progressive hyper-fluorescence is seen on fluorescein angiography with early hyperfluorescence followed by late hypofluorescence on indocyanine green angiography 2,7.…”

Bilateral choroidal haemangioma in an otherwise normal middle aged female

“…A"washout" effect in the late phase is observed due to egress of dye from the hemangioma. 4 Circumscribed choroidal hemangioma is mainly asymptomatic hence only observation and follow up is required in most cases. Traditional treatment for CCH was xenon arc photocoagulation.it produced good resolution without residual scarring that can cause good visual recovery.…”

Bilateral circumscribed haemangioma of the choroid not associated with systemic vascular syndrome

“…During the mid-term follow up (15 months) there were neither ocular nor systemic significant modifications. The echographic9 and ICGA1-3 10 features of these choroidal lesions, together with the lack of neoplasm or vascular abnormality in another part of the body, lead us to confirm the first documented diagnosis of bilateral CCHs. Last but not least, our findings demonstrate that FA and echography are not always capable of documenting the specific characteristics of small CCH; thus, when this kind of lesion is suspected, ICGA represents the most important non-invasive tool for the diagnosis2 to differentiate amelanotic choroidal melanoma, choroidal metastasis, and choroidal haemangioma 10…”

Circumscribed Choroidal Hemangioma Simulating Choroidal Melanoma on Advanced Ultrawide-Field Pseudocolor Retinal Imaging: A Case Series

“…[1][2][3][4][5][6][7][8] On ultrasonography, circumscribed choroidal hemangiomas have high internal refl ectivity on A-scan and are a solid, dome-shaped mass on B-scan. 2,16 Progressive hyperfl uorescence is seen on fl uorescein angiography with early hyperfl uorescence followed by late hypofl uorescence on indocyanine green angiography. 2,7 On enhanced depth imaging-optical coherence tomography (EDI-OCT), EDI-circumscribed choroidal hemangioma appears as a sloping choroidal mass with enlargement of medium-and large-sized choroidal vessels in the absence of choriocapillaris compression with intact Bruch's membrane complex.…”

“…Ancillary imaging of circumscribed choroidal hemangioma includes ultrasonography, fluorescein angiography, indocyanine green angiography, and optical coherence tomography 1–8. On ultrasonography, circumscribed choroidal hemangiomas have high internal reflectivity on A-scan and are a solid, dome-shaped mass on B-scan 2,16. Progressive hyper-fluorescence is seen on fluorescein angiography with early hyperfluorescence followed by late hypofluorescence on indocyanine green angiography 2,7.…”

Bilateral choroidal haemangioma in an otherwise normal middle aged female

“…A"washout" effect in the late phase is observed due to egress of dye from the hemangioma. 4 Circumscribed choroidal hemangioma is mainly asymptomatic hence only observation and follow up is required in most cases. Traditional treatment for CCH was xenon arc photocoagulation.it produced good resolution without residual scarring that can cause good visual recovery.…”