Purpose:

To discuss our treatment results of choroidal hemangiomas.

Material and Method:

The records of 39 cases of choroidal hemangioma followed up at our clinic between July 1999–October 2012 were reviewed retrospectively. Asymptomatic cases were followed up. Symptomatic cases with subretinal fluid and impaired vision received treatment.

Results:

Mean age of the 39 patients was 44 (12-80) years. Thirty-five of 39 cases had circumscribed choroidal hemangioma, and 4 cases had diffuse choroidal hemangioma. Sturge-Weber syndrome was present in 3 cases with diffuse choroidal hemangioma. Cases with circumscribed choroidal hemangioma and minimal subretinal fluid were treated with TTT in 11 cases, PDT in 12 cases, and PDT+TTT in 1 case. Cases with circumscribed choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy in 1 case, Ru-106 plaque radiotherapy+TTT in 1 case, EBRT in 3 cases, and TTT+EBRT in 1 case. One painful blind eye with neovascular glaucoma and complicated cataract was enucleated. Cases with diffuse choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy+TTT in 1 case and EBRT in 1 case. Ahmed glaucoma valve implantation and FAKO emulsification were applied to a case with neovascular glaucoma and complicated cataract. Complete resorption of subretinal fluid was achieved in 23 (72%) of treated 32 cases. When mean initial tumor thickness was 2.6 mm (0.5-6), mean final tumor thickness was 1.4 mm (0-6). When mean initial visual acuity (LogMAR) was 1.5 (0-3), mean final visual acuity was 1.1 (0-3). No recurrence was observed.

Discussion:

The amount of the subretinal fluid determines the method of treatment in circumscribed choroidal hemangioma. While TTT and PDT are effective treatment modalities for minimal subretinal fluid, plaque radiotherapy and EBRT are applied in cases with excessive subretinal fluid. Combination therapies may be necessary according to the persistence of subretinal fluid. Visual acuity is generally preserved and sometimes improved with treatment.

Keywords: Choroidal hemangioma, external beam radiotherapy, photodynamic therapy, plaque radiotherapy, transpupillary thermotherapy