Choroidal Hemangioma Masquerading as Central Serous Chorioretinopathy

C horoidal hemangioma is a relatively rare, benign vascular hamartoma. The circumscribed type is classically unilateral and is believed to be congenital in origin.1,2 Circumscribed choroidal hemangioma typically appears as a slightly oval or round, red-orange mass in the macular or perimacular region of the choroid, often with clinically indistinct borders.1-3 Although choroidal hemangioma is benign, this tumor can manifest progressive retinal detachment with poor visual acuity; rarely does this condition necessitate enucleation. In a review of 200 cases of choroidal hemangioma by Shields et al,1 54% of patients were found to have a visual acuity of 20/200 or worse at initial presentation, and enucleation was necessary in 3 cases. Thus, timely recognition and appropriate management of this tumor is important for visual outcome. Choroidal hemangioma can be misdiagnosed as amelanotic melanoma, choroidal metastasis, central serous chorioretinopathy (CSC), and, in some instances, it remains clinically undetected despite visual loss.1 Herein, we report a case of choroidal hemangioma that was clinically undetected despite visual loss for more than 1 year and later treated as CSC until an underlying subtle hemangioma was detected.