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Sioufi, Kareem, MD; Say, Emil A., T., MD; Ferenczy, Sandor, C., CRA, OCT-C; Shields, Carol, L., MD

doi: 10.1097/IAE.0000000000001709
Original Study

Purpose: To evaluate parafoveal microvasculature in eyes with circumscribed choroidal hemangioma using optical coherence tomography angiography.

Methods: Fourteen eyes with unilateral circumscribed choroidal hemangioma were imaged using OCT for central macular thickness and optical coherence tomography angiography for superficial and deep foveal avascular zone area, and superficial and deep capillary density (CD), comparing affected and paired fellow eyes.

Results: Mean patient age was 53 years, and mean visual acuity was 20/60 in the involved eye and 20/25 in the fellow eye. In the affected eye, clinical findings included cystoid macular edema (CME) in 1, parafoveal/subfoveal subretinal fluid (SRF) in three, and both CME and SRF in two eyes. OCT revealed current CME/SRF in six eyes, and normal foveal contour in eight eyes, among which five never demonstrated OCT evidence of CME or SRF. By OCT (affected vs. fellow eye), mean central macular thickness was greater in affected eyes (312 vs. 264 μm, P = 0.042). By optical coherence tomography angiography, there was no difference in superficial foveal avascular zone (P = 0.327), deep foveal avascular zone (P = 0.563), and superficial CD (P = 0.159), but mean deep plexus CD was reduced in affected eyes (50% vs. 54%, P = 0.010). Subgroup analysis showed that eyes with previous or current CME and/or SRF had reduced deep plexus CD (53% vs. 57%, P = 0.005), while eyes without previous/current CME/SRF had similar deep plexus CD (P = 0.399) compared with fellow eyes.

Conclusion: Circumscribed choroidal hemangioma generally does not affect parafoveal inner retinal microvasculature. However, a reduction in deep plexus CD can be expected in eyes with previous or current CME/SRF.

Eyes with circumscribed choroidal hemangioma demonstrated reduced parafoveal deep plexus density on optical coherence tomography angiography when associated with subretinal fluid and/or cystoid macular edema.

Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.

Reprint requests: Carol L. Shields, MD, Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, 840 Walnut Street, Suite 1440, Philadelphia, PA 19107; e-mail:

Support provided by Eye Tumor Research Foundation, Philadelphia, PA. The funders had no role in the design and conduct of the study, in the collection, analysis and interpretation of the data, and in the preparation, review, or approval of the manuscript.

C. L. Shields, has had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The remaining authors have no conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.