Título / Title

CIRCUMSCRIBED CHOROIDAL HEMANGIOMA - MULTIMODAL DIAGNOSIS

Introdução / Purpose

to illustrate the importance of multimodal diagnosis in two cases of circumscribed choroidal hemangioma (CCH), their differential diagnoses and treatment.

Material e Método / Methods

Multimodal evaluation was performed in both patients: biomicroscopy (BIO), indirect fundoscopy (IF), ocular ultrasound (USG), autofluorescence (AF), and optical coherence tomography (OCT).

Resultados / Results

Both patients presented decreased visual acuity (VA) in one eye and presented a single lesion to the IF, well circumscribed, elevated, orange-red, located posteriorly. They also presented subretinal fluid (SRF) in the macula. The USG of both patients revealed a solid circumscribed lesion with high internal reflectivity in the A-scan. The dimensions were 2,3 x 4,9 mm in patient 1, and 7,7 x 4,5 mm in patient 2. The AF of the patients revealed that both tumors were hypo-autofluorescent, surrounded by perilesional hyper-autofluorescence. In the OCT, the lesions were elevated, well-delimited, with cystic degeneration of the internal retina, hyporreflective choroidal bulging and macular neurossensorial retinal detachment. The Bruch membrane was preserved, however there was absence pre-tumor ellipsoid and irregularity of the nuclear and out plexiform layers. Based on the multimodal evaluation performed, both patients were diagnosed with CCH and retinal photocoagulation was performed in both tumors, evolving with resolution of the SRF and improving the VA. They remained stable in the 6-month follow-up, without secondary complications.

Discussão e Conclusões / Conclusion

It is important to differentiate between types of eye tumors to provide adequate treatment, reducing morbidity and mortality. CCH is a benign vascular tumor whose main differential diagnoses are choroidal metastasis and amelanotic melanoma, which are lethal tumors, being the most assertive and non-invasive multimodal diagnosis. Photocoagulation as a treatment for secondary retinal detachment was an affordable, effective and safe alternative to restore VA.

Palavras Chave

circumscribed choroidal hemangioma; multimodal diagnosis; differential diagnoses

Area

CLINICAL RETINA