Fig. 27.1

Circumscribed choroidal hemangioma.

by patient self-monitoring with an Amsler grid to facilitate early detection of retinal detachment near the macula.

Laser The decision to treat a choroidal hemangioma is influenced by the extent of visual loss and the potential for visual recovery. Laser therapy, radiotherapy, transpupillary thermotherapy and cryotherapy have been applied to areas of retinal detachment that threaten vision. More recently, photodynamic therapy using verteporfin has yielded promising results, particularly in circumscribed

choroidal hemangiomas. The principal complication of photodynamic therapy is choroidal ischemia, which may cause sudden permanent vision loss within 24 hours of treatment; longer-term followup studies will reveal the efficacy and safety of this treatment modality. Historically, the long-term visual prognosis of choroidal hemangioma has been poor, even in adequately treated patients.

Referral Referral to a neurologist is often appropriate for patients with SturgeWeber syndrome.

Choroidal hemangioma