Subretinal Fluid Optical Density and Spectral-Domain Optical Coherence Tomography Characteristics for the Diagnosis of Circumscribed Choroidal Hemangioma

Abstract

Purpose: To investigate spectral domain-optical coherence tomography (SD-OCT) features of untreated circumscribed choroidal hemangioma (CCH), and the optical density (OD) of the associated subretinal fluid (SRF). Procedures: This international retrospective multicenter study conducted at 5 tertiary retina referral centers included 34 patients with symptomatic CCH imaged on SD-OCT. CCH surface, size, and overlying retinal changes and OD ratio (ODR) were evaluated. Results: The mean ODR of the SRF was 0.808 ± 0.287. Tumor base measured on ultrasound correlated significantly with the ODR (p = 0.012). ODR values in cases of CCH were similar to those of choroidal metastasis, but significantly lower than those of choroidal melanoma (p = 0.006). Thirty-two out of 34 cases (94%) presented with a regular smooth choroidal surface. OCT demonstrated SRF overlying the CCH in 29 eyes (85%). The presence of SRF correlated significantly with a larger basal tumor diameter (p = 0.035). OCT displayed sub- and intraretinal hyperreflective foci, correlating with both larger maximal retinal thickness overlying the tumor (p = 0.031) and the amount of SRF (p = 0.016) in 29 eyes (85%). Conclusion: CCH displays typical findings on SD-OCT. ODR is a new important tool in the differential diagnosis of choroidal tumors and should be considered for enhancing the accuracy of diagnosing CCH. This benefit is especially relevant for cases in which the presentation of CCH is atypical.

Optical Density Ratio of Subretinal Fluid in Choroidal Melanomas Versus Choroidal Naevi Assessed by Optical Coherence Tomography

“…Our results are consistent with the observations by Leshno et al 9 and Zur et al 9 , 10 regarding the higher ODR of SRF in choroidal melanoma than in other benign or malignant choroidal lesions. Our findings demonstrate that choroidal melanoma have also higher SRF ODR than choroidal naevus.…”

“…They computed using a receiver operating characteristic (ROC)-curve approach with a cutoff value of 0.771 with sensitivity of 78.6% and specificity of 72.0%. Another study by the same group by Zur et al 10 also identified a higher SRF ODR in 25 cases with choroidal melanoma, compared with 34 cases with circumscribed choroidal hemangioma.…”

“…Moreover, a range of additional findings supported this observation, including a significantly higher SRF ODR among choroidal naevi that later transformed into melanoma over a 3-year follow-up, compared to a subset of matched choroidal naevi of similar size that did not transform. ODR of SRF had been previously explored in choroidal tumors, 9 , 10 but, to the best of our knowledge, had not been comparatively analyzed in choroidal melanomas and naevi.…”

“…To date, few studies have evaluated the optical density of SRF using OCT, only two in the context of intraocular tumors, but not comparing choroidal naevi and melanomas. 9 , 10 It has been shown that optical density measurements of SRF differ between degenerative and exudative macular disease, 11 , 12 and can be used as a biomarker to differentiate various etiologies of SRF. 11 , 13 …”

Polypoidal Lesions Associated with Choroidal Nevi: a trouble diagnosis.

“…We wonder if these kinds of lesions could be hemangiomas. In fact, on optical coherence tomography, hemangioma is characterized by: 9,10 Localized choroidal mass with large inherent vasculature, without choroidal vessels compression.Subretinal fluid and cystic retinal degeneration may be present above the tumor.Tumor mass exhibits a hyporeflective internal signal.…”