Circumscribed choroidal hemangiomas

R. Anand, J. J. Augsburger and J. A. Shields
Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.

We report observations of 71 patients with circumscribed choroidal hemangiomas. Each of these patients had a unilateral choroidal tumor with characteristic ophthalmoscopic, fluorescein angiographic, and ultrasonographic features. The affected patients ranged in age from 9 to 86 years when diagnosed. Sixty-four (90%) of the 71 patients were followed up by use after their initial diagnostic examination. The median follow-up was 45.5 months (range, 6 weeks to 12 years). Forty-two of the 64 patients were treated with scatter photocoagulation to the tumor surface on one or more occasions for vision-impairing or vision-threatening nonrhegmatogenous retinal detachment. The subretinal fluid resolved following photocoagulation in all of these eyes, and the vision stabilized in 34 patients (53%). However, the visual acuity at the most recent follow-up was less than 6/15 in 46 (72%) of the 64 affected eyes. Scatter photocoagulation, as employed in this group of patients, frequently results in retinal reattachment and temporary visual improvement, but many patients have permanently decreased vision in the affected eye, particularly when the tumor or the retinal detachment affects the foveal area. One third of the patients with 6/60 or better visual acuity at presentation are estimated to deteriorate to less than 6/60 visual acuity within 10 years.

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