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Yasmin Poustchi, Swathi Kaliki, Carol L. Shields; Choroidal Hemangioma Masquerading as Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4938.
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To describe a case of choroidal hemangioma that was clinically undetected despite visual loss for over 1 year and later treated as central serous chorioretinopathy until an underlying subtle choroidal hemangioma was detected.
A 46-year-old healthy Caucasian female presented with 1-year history of mild decreased visual acuity in the right eye to 20/30. Fundus examination OD revealed shallow subretinal fluid and a subtle orange-colored choroidal mass in the peripapillary area of 4 x 3 mm in diameter. A-scan ultrasonography OD revealed high internal reflectivity, and B-scan ultrasonography revealed a solid, acoustically dense, dome-shaped, 2.3 mm thick choroidal mass. Enhanced depth imaging-optical coherence tomography (EDI-OCT) revealed compression of choriocapillaris, thinning of retinal pigment epithelium, atrophy of photoreceptors, loss of inner segment-outer segment junction, irregularity of external limiting membrane, and confirmed the presence of perifoveal subretinal fluid.
The features were consistent with choroidal hemangioma and photodynamic therapy (PDT) was performed using standard parameters. One year following PDT, the tumor appeared stable and subretinal fluid nearly resolved. Visual acuity was stable at 20/30, likely related to chronic outer retinal changes from previous fluid.
In this case, choroidal hemangioma was misdiagnosed as CSCR. Careful clinical examination in conjunction with ultrasonography and optical coherence tomography allows appropriate diagnosis and timely treatment of choroidal hemangioma.
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