ABSTRACT
We describe a case report of a spontaneous suprachoroidal hemorrhage, in which the enhanced depth imaging optical coherence tomography (OCT-EDI) is extremely useful in establish the differential diagnosis with a choroidal tumor. A 70 year-old woman was referred with a central scotoma after a Valsalva maneuver. In the posterior pole we observed a grey bilobed subretinal mass with the appearance of a choroidal tumor. OCT-EDI revealed an optically dark region with a scalloped anterior tumor contour and subretinal fluid, the choroicapillaris appeared to be intact and displaced anteriorly. The diagnosis was a suprachoroidal hemorrhage and it resolved in 12 weeks. Spontaneous suprachoroidal hemorrhage is a rare condition and it can resemble choroidal tumor. OCT-EDI is a very valuable tool in the differentiation of hemorrhage from tumors.
Subject(s)
Choroid Hemorrhage , Choroid Neoplasms , Valsalva Maneuver , Aged , Choroid Hemorrhage/diagnosis , Choroid Hemorrhage/etiology , Choroid Neoplasms/diagnosis , Diagnosis, Differential , Female , Humans , Tomography, Optical CoherenceABSTRACT
Presentamos el caso clínico de una hemorragia supracoroidea espontánea, en el que la tomografía de coherencia óptica de profundidad mejorada (OCT-EDI) resulta de gran utilidad para el diagnóstico diferencial con un tumor coroideo. Una mujer de 70 años con hipertensión arterial, acude por escotoma central tras maniobra de Valsalva. En el fondo de ojo observamos una masa bilobulada central, subretiniana y grisácea, que plantea diagnóstico diferencial con un tumor coroideo. En la OCT-EDI se observa una masa coroidea con superficie de tipo festoneado y líquido subretiniano, el tejido coriocapilar se encuentra desplazado anteriormente con apariencia normal. Diagnosticamos una hemorragia supracoroidea, que se resuelve espontáneamente en 12 semanas. La hemorragia supracoroidea espontánea es muy poco frecuente y presenta una imagen que puede ser confundida con un tumor coroideo, la OCT-EDI es la prueba de imagen más útil para el diagnóstico diferencial (AU)
We describe a case report of a spontaneous suprachoroidal hemorrhage, in which the enhanced depth imaging optical coherence tomography (OCT-EDI) is extremely useful in establish the differential diagnosis with a choroidal tumor. A 70 year-old woman was referred with a central scotoma after a Valsalva maneuver. In the posterior pole we observed a grey bilobed subretinal mass with the appearance of a choroidal tumor. OCT-EDI revealed an optically dark region with a scalloped anterior tumor contour and subretinal fluid, the choroicapillaris appeared to be intact and displaced anteriorly. The diagnosis was a suprachoroidal hemorrhage and it resolved in 12 weeks. Spontaneous suprachoroidal hemorrhage is a rare condition and it can resemble choroidal tumor. OCT-EDI is a very valuable tool in the differentiation of hemorrhage from tumors (AU)
Subject(s)
Humans , Female , Aged , Choroid Hemorrhage/diagnostic imaging , Choroid Hemorrhage/etiology , Tomography, Optical Coherence , Valsalva Maneuver , Diagnosis, DifferentialABSTRACT
OBJECTIVE: To study the effectiveness and limitations of photodynamic therapy (PDT) as treatment of choice in patients with symptomatic circumscribed choroidal haemangioma. METHODS: A retrospective study was conducted on 16 patients (13 men and 3 women, with mean age of 54.88 years) with circumscribed choroidal haemangioma, who attended our centre and were treated with PDT in the last 7 years. RESULTS: All patients had circumscribed choroidal haemangioma, which caused a decrease in visual acuity (VA) secondary to the presence of intraretinal microcystic oedema or neurosensory detachment. The mean initial VA was 0.23, and the final mean VA after performing PDT was 0.38 (all the VA were measured in decimal scale). It should be noted that patients needed a mean of 1.69 PDT sessions. Three of the patients needed rescue treatment with trans-pupillary thermotherapy, intravitreal injection of anti-vascular endothelial growth factor (ranibizumab, aflibercept) or a dexamethasone intravitreal implant (Ozurdex®). The indication for a change of treatment was the persistence of intraretinal microcystic oedema and/or neurosensory detachment (or incomplete resolution) after 3 PDT sessions. As overall results, 62.5% of patients evolved into anatomical and functional (increase in AV or stability) resolution. CONCLUSIONS: PDT is a straight forward and fast procedure, with a good anatomical and functional response, causing minimal damage to adjacent vessels.
