Optical coherence tomography angiography features of choroidal hemangioma

Abstract

This is an observational case series of four cases of choroidal hemangioma. All cases underwent OCT angiography with swept source OCTA (Topcon DRI OCT Triton plus) 6 mm * 6 mm protocol. OCTA at the level of large choroidal vessels demonstrated peculiar vascular pattern in all four eyes. Patterns observed were bag of worms, spaghetti like and vessels with terminal bulbs. In eye with diffuse choroidal hemangioma comparison of choroidal vascular pattern with the contralateral eyes showed significant difference in the vascular architecture. OCTA is an excellent non invasive tool in assessing the choroidal vascular pattern in eyes with choroidal hemangioma.

Keywords: Choroid; hemangioma; optical coherence tomography angiography; tumor.

Figure 1

(a) Color photograph of the left eye showing circumscribed choroidal hemangioma superior to the disc with subretinal fluid at macula (b) optical coherence tomography showing subretinal fluid at the fovea (c) fluorescein angiography showing mottled hyperfluorescence in early phase. (d) Optical coherence tomography angiography at the level of superficial choriocapillary layer showed multiple whitish irregular vessels resembling bag of worms. Yellow dotted line indicates the line of transition from irregularly arranged tumor vessels to regularly arranged normal vessels. (e) Optical coherence tomography angiography at deeper choroidal vessels demonstrated club-like appearance (yellow arrows)

Figure 2

(a) color photograph of the right eye showing an orange lesion superior to disc with shallow subretinal fluid at the fovea. (b) Optical coherence tomography angiography at the level of superficial choriocapillary layer showed irregularly arranged vessels with corresponding level of segmentation. (c) Optical coherence tomography angiography at deeper choroidal slabs showed irregular choroidal vessels with “club-like” appearance (yellow arrows)

Figure 3

(a) Color photograph showing reddish orange elevated choroidal mass temporal part of the fovea. (b) Early phase of fluorescein angiography of the left eye showing mottled hyperfluorescence. (c) Optical coherence tomography angiography at the level of superficial choriocapillary layer showed irregularly arranged vessels. (d) Optical coherence tomography angiography at the level of deeper choroidal slabs showed irregular choroidal vessels with few “club-like” appearance. Yellow dotted line indicates the signal void areas

Figure 4

(a) Right eye photo showing significant cupping, reddish flat lesion in inferior half of fundus below the fovea. (b) color photograph of the right eye showing inferonasal margin of diffuse choroidal hemangioma (red arrows). (c) Optical coherence tomography of the right eye shows that the choroidal thickness abruptly increased inferior to fovea (white arrow). White dotted lines indicate the choroid sclera interface. (d) Optical coherence tomography angiography in the right eye showed choroidal vessels arranged like fine threads. Red arrows indicate the margin of tumor. (e) Optical coherence tomography angiography of the left eye showing normal choroidal vasculature