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Choroidal Haemangioma

a) What is choroidal haemangioma?

Choroidal haemangiomas are benign tumours that grow in the blood vessel layer beneath the retina called the choroid. They are either circumscribed or diffuse. Circumscribed means there is no underlying medical condition. Diffuse choroidal haemangiomas, however, are commonly found in a condition called Sturge-Weber syndrome. The vision is more likely to be affected in this type. Although not as common, haemangiomas can be found in the iris and ciliary body. This can sometimes cause glaucoma.

b) What are the symptoms of choroidal haemangioma?

Commonly there are no symptoms and your optician finds them on routine examination. Sometimes, however, the choroidal haemangioma can leak fluid underneath the retina at the back of the eye. This may cause:

• Blurred vision

• Distortion

• Hypermetropia (change in perscription making you long sighted)

• Flashing lights If there is a lot of fluid leakage at the back of the eye, this can cause a retinal detachment. This may cause floaters, flashing lights, and a curtain over the vision.

c) Will I need any tests?

Some tests can help us confirm the diagnosis and see if the haemangioma is leaking fluid. These may include:

• Ultrasound Scan

• Optical coherence tomography (OCT)

• Fundus fluorescein angiography (FFA)

• Indocyanine green chorioangiography (ICG)

d) What is the treatment for choroidal haemangioma?

If there are no symptoms, no treatment is required. If, however, the haemangioma is growing, leaking or starting to affect the vision, we may use the following treatments:

  • Photodynamic therapy (PDT)
  • Laser (Traspupillary thermotherapy)
  • Plaque radiotherapy
  • Proton Beam Radiotherapy

e) Is treatment of choroidal haemangioma successful?

Laser photocoagulation helps seal the leaking blood vessels. Unfortunately, fluid can build up again. PDT and Transpupillary thermotherapy have both shown great successful in stopping leakage from choroidal haemangiomas. If the retina has detached, however, giving these treatments can be too difficult. Radiotherapy treatment may be preferred in these cases. The longer fluid is at the back of the eye or the retina is detached, the smaller the chance of having complete recovery of vision after treatment.

f) Will choroidal haemangioma spread to other parts of the body?

No. This is a benign tumour and does not metastasise.