Choroidal Hemangioma

Choroidal hemangioma is a benign and relatively rare hamartomous tumor. There are two forms: a discret form and a diffuse form. The diffuse form is generally associated with the Sturge-Weber-Syndrome.

The discrete or circumscribed form is located posterior to the equator and temporal to the optic disc, but usually does not extend under the foveola. It is elevated, round or oval and has a pinkish, flesh-colored, grayish or yellowish orange red or mottled orange or gray color.

Treatment is limited to the amount of photocoagulation necessary to resolve the serous retinal detachment that involves or threatens the fovea.

Proton beam irradiation has been used. At this point in time, it is likely that some form of radiotherapy is the most effective primary treatment for symptomatic patients with subretinal fluid. Early treatment is advocated. Although virtually all the eyes treated with some form of radiotherapy will have successful resolution of the fluid, the long term prognosis for good visual acuity may be guarded if the tumor is located under the fovea or extremely near the fovea.

The differential diagnosis includes amelanotic choroidal melanoma, metastatic choroidal tumor, choriodal osteoma, central serous chorioretinopathy, posterior scleritis, disciform macular degeneration, and retinoblastoma. Ultrasound appearance is characteristic.