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Arun D Singh, Jorgen Krohn, Pukhraj Rishi; Circumscribed Choroidal Hemangioma : Topographical Features. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5590. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize the topographical features of circumscribed choroidal hemangioma (CCH) and to visualize the pattern of tumor extent in the ocular fundus.
The study included a total of 114 consecutive patients with CCH referred to the centers in Bergen, Chennai or Cleveland during the period 2002-2017. Ophthalmoscopy, fundus photography, ultrasonography, ICG- and fluorescein angiography, OCT and MRI were used to obtain data on the size, shape and location of the tumors, which were converted into a database of two-dimensional retinal charts by means of a computer-drawing software. The geometric centers and extent of the tumors were visualized by merging the charts and displaying the number of overlapping tumors on color-coded contour maps.
Forty-two females and 72 males with a mean age of 57 years (range, 4-93) were included. The mean largest tumor diameter was 7.3 mm (range, 2.5–11.5), mean tumor height was 2.4 mm (range, 0.7–4.8), and mean diameter/height ratio was 3.2 (range, 2.1–6.0). The CCH appeared as round in 60 (53%) eyes, oval in 36 (31%), and irregular in 18 (16%). Subretinal fluid was present in 77 eyes (68%) and retinal edema in 48 (42%). Pigmentary changes were noted in 38 (33%) eyes, retinal lipid exudates in 16 (14%), and overlying drusen in 9 (8%). The mean distance from the posterior tumor margin to the foveola and optic disc was 1.7 mm (range, 0–15) and 2.4 mm (range, 0–11), respectively. All CCH were located posterior to the equator. The hemispheric location of the geometric tumor center was temporal in 75 eyes (66%) and nasal in 39 (34%) (p < 0.001), and the distribution between the superior and inferior hemispheres was 68 (60%) and 46 (40%), respectively (p = 0.04). The distribution did not differ by age, gender or tumor size. More CCH associated with subretinal fluid exudation were located in the nasal hemisphere compared with the temporal hemisphere (p = 0.006), and exudation was significantly associated with a low tumor diameter/height ratio (p = 0.0003) and close proximity to the optic disc (p = 0.004).
Both the distribution of the geometric tumor centers and the merged retinal charts demonstrate that the superotemporal quadrant posterior to the equator is the preferential location of CCH. The tumors are also generally characterized by a high diameter/height ratio of >2. Factors associated with subretinal fluid exudation are tumor elevation and proximity to the optic disc.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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