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Patient ReportsChoroidal Hemangioma: What It Is and How It Is Treated
Written by Medicover Team and Medically Reviewed by Dr Kirti Mane , ophthalmologists
Table of Contents
Choroidal hemangioma is a rare, benign blood-vessel tumor that develops in the choroid, the vascular layer located between the retina and the outer wall of the eye. It is usually noncancerous and may occur as an isolated lesion or, less commonly, as part of a genetic condition such as Sturge-Weber syndrome.
Many choroidal hemangiomas cause no symptoms and may be discovered incidentally during a routine eye examination. When the lesion affects the retina or causes fluid to accumulate under the retina, it can lead to blurred or distorted vision. Early evaluation by an ophthalmologist is important when vision changes occur.
What are the Types of Choroidal Hemangioma?
Choroidal hemangiomas are generally classified according to whether they occur alone or in association with another condition.
- Circumscribed Choroidal Hemangioma: A localized, well-defined vascular lesion that usually occurs as an isolated abnormality in one eye.
- Diffuse Choroidal Hemangioma: A more widespread thickening of the choroid that is commonly associated with Sturge-Weber syndrome.
The appearance, location, and effect on vision can vary from person to person.
What are the Symptoms and Warning Signs of Choroidal Hemangioma?
Small or inactive choroidal hemangiomas may not produce any symptoms. Symptoms generally occur when the lesion affects the retina or causes fluid to collect beneath it.
Common Symptoms
- Blurred or reduced vision
- Distorted vision, in which straight lines may appear wavy
- Changes in visual clarity
- Flashing lights or visual disturbances in some cases
- Difficulty seeing clearly in the affected eye
Severe Symptoms
- Significant or progressive loss of vision
- Persistent distortion of central vision
- Retinal detachment caused by fluid accumulation in severe cases
- Rarely, secondary complications affecting the macula and vision
What are the Causes and Risk Factors of Choroidal Hemangioma?
The exact cause of choroidal hemangioma is not fully understood. These lesions are thought to result from abnormal development or proliferation of blood vessels within the choroid.
Causes
- Abnormal blood-vessel development: Changes in the vascular tissue of the choroid can result in formation of a hemangioma.
- Congenital vascular abnormalities: Some lesions may be related to vascular developmental abnormalities present from birth.
- Genetic conditions: Diffuse choroidal hemangiomas can occur as part of Sturge-Weber syndrome.
Risk Factors
- Presence of Sturge-Weber syndrome
- Congenital vascular abnormalities
- History of other vascular malformations
Choroidal hemangioma is not considered a cancerous tumor, and there are no established lifestyle factors known to directly cause it.
When to See a Doctor?
Any unexplained change in vision should be evaluated by an eye specialist. Early assessment can help identify whether a choroidal lesion is affecting the retina or causing fluid accumulation.
- New or worsening blurred vision
- Distorted or wavy vision
- Persistent visual disturbances
- Sudden changes in vision
- Known choroidal hemangioma with worsening symptoms
- Eye findings associated with Sturge-Weber syndrome
Sudden or severe vision loss requires urgent ophthalmic assessment.
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How is Choroidal Hemangioma Diagnosed?
Diagnosis requires a detailed eye examination and imaging of the retina and choroid. Because other eye tumors can sometimes resemble a choroidal hemangioma, specialized imaging helps confirm the diagnosis.
Diagnostic Tests
- Comprehensive eye examination: An ophthalmologist examines the retina, choroid, and other structures of the eye.
- Fundus examination: Helps identify the characteristic appearance and location of the lesion.
- Optical coherence tomography (OCT): Provides detailed images of the retina and can detect fluid beneath the retina.
- Ocular ultrasound: Helps evaluate the size, thickness, and internal characteristics of the lesion.
- Fluorescein angiography: Shows blood flow through the lesion and can help assess associated retinal changes.
- Indocyanine green angiography: Provides detailed information about blood vessels within the choroid.
- MRI: May be used when additional evaluation of the eye or associated conditions is required.
In many cases, imaging provides enough information to make the diagnosis without a biopsy.
What are the Treatment Options for Choroidal Hemangioma?
Treatment depends on the size and location of the hemangioma, whether it is causing symptoms, and whether fluid accumulation is affecting vision. Asymptomatic lesions may simply be monitored.
Observation
Small choroidal hemangiomas that do not affect vision may not require immediate treatment. Regular eye examinations and imaging can monitor for changes.
Laser and Light-Based Treatments
- Photodynamic therapy (PDT): Uses a light-sensitive medication and a specific laser wavelength to target abnormal blood vessels. It is commonly used for symptomatic circumscribed choroidal hemangiomas.
- Laser photocoagulation: May be considered in selected cases, although it is used less often because of the risk of damaging surrounding retinal tissue.
Other Medical Treatments
- Anti-VEGF injections: May be used in selected patients when significant fluid accumulation or retinal complications are present, particularly as an adjunct to other treatments.
- Corticosteroid treatment: May occasionally be considered in selected situations, depending on the cause of retinal or subretinal fluid.
Radiation Therapy
Radiation-based treatments may be considered for selected lesions that are difficult to treat with other approaches or when other treatments are unsuccessful. The choice depends on the lesion's characteristics and the patient's visual needs.
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What is the Recovery Process After Choroidal Hemangioma Treatment?
Recovery depends on the treatment used and the extent of retinal damage or fluid accumulation before treatment. The goal is to control the lesion and preserve or improve vision.
After Treatment
- Attend scheduled ophthalmology follow-ups.
- Undergo repeat OCT or other imaging when recommended.
- Monitor for changes in visual acuity or distortion.
- Follow post-treatment eye-care instructions carefully.
- Report new or worsening vision changes promptly.
Long-Term Outlook
Choroidal hemangiomas are benign and may remain stable for many years. When treatment is needed, controlling the lesion and associated retinal fluid can help preserve vision. Long-term monitoring may be necessary because visual complications can recur.
What Precautions Can Help Prevent Choroidal Hemangioma?
There are no proven measures that can completely prevent choroidal hemangioma because its development is generally related to vascular or congenital factors rather than lifestyle choices.
Prevention and Eye Care
- Attend routine comprehensive eye examinations.
- Seek prompt evaluation for unexplained changes in vision.
- Follow recommended monitoring if a choroidal lesion has already been identified.
- Manage associated genetic or vascular conditions with appropriate specialists.
- Protect the eyes from trauma during high-risk activities.
Possible Complications
- Subretinal fluid accumulation
- Retinal or macular changes
- Progressive visual distortion
- Reduced visual acuity
- Rarely, retinal detachment or significant vision loss
Our Experience Treating Choroidal Hemangioma
At Medicover Hospitals, patients with choroidal hemangioma receive comprehensive ophthalmic evaluation to determine the lesion's size, location, activity, and effect on vision. Our eye specialists use detailed retinal imaging and other diagnostic techniques to distinguish choroidal hemangioma from other ocular lesions.
When treatment is required, the care plan is tailored to the patient's individual condition and may include observation, photodynamic therapy, injections, or other appropriate interventions. Regular follow-up helps monitor the lesion and protect long-term visual function.
Frequently Asked Questions
1. What is a choroidal hemangioma?
A choroidal hemangioma is a benign blood-vessel tumor in the choroid, the vascular layer beneath the retina. It may be present from birth or develop later.
2. What are the symptoms of choroidal hemangioma?
Small tumors may cause no symptoms. Larger lesions can cause blurred vision, reduced vision, visual distortion, or fluid buildup under the retina.
3. What causes choroidal hemangioma?
The exact cause is not fully understood. Most cases occur sporadically, while some may be associated with Sturge-Weber syndrome.
4. How is choroidal hemangioma diagnosed?
Diagnosis may involve a dilated eye examination, ocular ultrasound, optical coherence tomography (OCT), and other retinal imaging tests.
5. How is choroidal hemangioma treated?
If treatment is needed, options may include photodynamic therapy (PDT), laser treatment, or injections of medicines into the eye to control fluid and protect vision.
6. Is choroidal hemangioma cancerous?
No. A choroidal hemangioma is benign and does not usually become cancerous, but it can affect vision if it causes retinal fluid or other complications.
