Choroidal Futures of Eyes with Circumscribed Choroidal Hemangioma in Ultra Wide-Field Optical Coherence Tomography Angiography

Abstract

Purpose : A recent innovation in OCT-Angiography (OCTA) provides images with enhanced imaging depth of 12mm on an extended field of view of 21mmx26mm, allowing a precise assessment of choroidal vascular alterations. This study aims to evaluate the ultra wide-field choroidal and vascular findings in eyes with circumscribed choroidal hemangioma (CCH) as depicted by the Dream-OCT (Intalight, Shanghai, China).

Methods : Consecutive patients with CCH were included in this cross-sectional case-study at the Department of Ophthalmology and Optometry, Medical University of Vienna. The diagnosis was previously confirmed with echo- and angiography. Full ophthalmic examination, best-corrected visual acuity (BCVA) and a ultra wide-field (UWF) OCTA were performed. Choroidal vascularity index (CVI), central retinal thickness (CRT) and choroidal thickness (CT) were assessed on study eyes (SE) and healthy fellow eyes (FE) using the software of the OCTA device. Measurement of CT excluded the area of CCH.

Results : Nine patients (female n=3 (33.3%); median age=68 years (interquartile range (IQR) 23.5 years)) were included in the study. Median duration of disease was 44 months (IQR 81 months) and median BCVA (logMAR) was 0.3 (IQR 1.0). In UWF-OCTA median area of CCH was 26.0mm² (IQR 27.3mm²). In sonography median largest basal diameter, smallest basal diameter and thickness were 8.3mm (IQR 3.6mm), 6.0mm (IQR 3.4mm) and 2.7mm (IQR 1.1mm), respectively. CVI was significantly lower in SE (median 0.40 (IQR 0.07) vs 0.43 (IQR 0.07); Wilcoxon-Test p=0.008), while CT was significantly higher in SE (median 315μm (IQR 91μm) vs 259μm (IQR 54μm), Wilcoxon-Test p=0.022). Despite 6 patients (66.7%) presented with intra- and/or subretinal fluid proximal to CCH, there was no difference in CRT (median 313μm (IQR 155μm) vs 307μm (IQR 44μm), Wilcoxon-Test p=0.066), as fluid was sometimes localized in the periphery proximal to CCH.

Conclusions : CCH could be precisely detected in WF-OCTA with increased depth. CT is higher and CVI is lower in SE as compared to FE.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

62-year-old male patient with pretreated CCH. A: Display of automatically annotated choroidal vessels for the calculation of CVI. Red arrows indicate CCH with different vessel pattern. Green line indicates location of image B. B: B-Scan of CCH with enhanced depth imaging.