Choroidal hemangioma

A hemangioma is benign intraocular tumour that involves the growth of vascular spaces in the posterior layer of the eye containing the greatest density of blood vessels (posterior uvea or choroid), located between the sclera (the white part of the eye) and the retina.

A hemangioma is usually located near the optic nerve or the central part of the retina. When this lesion is active it loses liquid which gradually accumulates below the retina leading to a reduced and/or distorted vision.  

A clinical examination is used to diagnose the majority of cases, but it is usually helpful to do complementary tests to obtain morphometric data (morphology, size and outcomes). An ocular ecography and an indocyanine green angiography are usually needed to confirm the diagnose and properly plan a course of treatment. 

A choroidal hemangioma can be localised, circumscribed (which is the most common) or even diffuse. The diffuse type is more serious and is usually associated with a general syndrome called Sturge Weber, in which hemangiomas typically appear on the face (a port-wine stain) and it occasionally causes neurological problems.

Treatment depends on the size and complications associated with the hemangioma. The most commonly used treatment is photodynamic therapy, which involves applying a laser to the lesion after injecting an endovenous drug. It is a very effective treatment for the majority of symptomatic cases. 

Whenever the lesion is larger or a lot of liquid has accumulated under the retina, then episcleral brachytherapy or different types of external radiotherapy are used.