Vascular tumors of the retina and choroid: Diagnosis and treatment

Abstract

The vascular tumors of the retina and choroid comprise a diverse group of congenital and acquired lesions. The major vascular tumors of the retina include retinal capillary hemangioma, cavernous hemangioma of the retina, retinal vasoproliferative tumor, and racemose hemangiomatosis of the retina or Wyburn–Mason syndrome. Choroidal vascular tumors include circumscribed choroidal hemangioma and diffuse choroidal hemangioma. While classified as benign, visual symptoms secondary to exudative retinal detachment and a variety of other mechanisms are common and are a major source of long-term visual disability. While many therapeutic modalities exist, treatment of symptomatic cases can be challenging. Of particular importance, many of the vascular tumors of the retina and choroid have significant associations with systemic disease. As ocular symptoms are often the most common presenting disease manifestation, the ophthalmologist plays an important role in accurate and early diagnosis. The ability to initiate prompt screening and treatment in appropriate cases is critical. In the following article, the key clinical and diagnostic features of the major retinal and choroidal vascular tumors, their systemic associations, and the literature pertaining to the most currently available treatment strategies are reviewed.

Detection of retinal microvascular changes in von Hippel-Lindau disease using optical coherence tomography angiography

“…Additionally, B-scan, A-scan, and optical coherence tomography (OCT) of the macula can also be informative in aiding the diagnostic process. [24] Optical coherence tomography angiography (OCT-A), a novel imaging tool, has been increasingly utilized for evaluating the retinal microvasculature and detecting both retinal and choroidal diseases. Given its non-invasive nature and the ability to produce three-dimensional images, OCT-A is considered an adjunct to traditional imaging methods, such as FA.…”

Precise diagnosis of choroidal hemangioma

“…отграниченной ГХ возникают на 4-5-м десятилетии жизни. Клиническая картина ее многократно описана в литературе [1][2][3]. Главная отличительная особенность -оранжево-красный или оранжево-желтый цвет опухоли.…”

“…Жалобы на зрительные расстройства при ГХ длительное время отсутствуют. Появление их связано с развивающимися изменениями в надлежащей сетчатке [2][3][4][5].…”

“…В последние годы оптическая когерентная томография (ОКТ) как метод прижизненного морфологического исследования сетчатки получает все большее распространение для диагностики внутриглазных опухолей, в частности ГХ [2,6,[8][9][10][11]. Обращают внимание на куполообразное возвышение РПЭ над гемангиомой, наличие суб-и интраретинальной жидкости, расслоение сетчатки, потерю фоторецепторов и атрофию сетчатки [2,6]. При длительном анамнезе выявляют изменения в РПЭ в сочетании с субретинальным фиброзом.…”

Primitive Retinal Vascular Abnormalities: Tumors and Telangiectasias

“…They may be sporadic or associated with intracranial cavernous hemangiomas and angiomatous skin hamartomas (neuro-oculo-cutaneous syndromes, i.e. phakomatoses) [19,20]. Patients may be asymptomatic or present reduction of VA if the lesion is located in the macula or associated with vitreous hemorrhage [6].…”