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Background <p>Circumscribed choroidal hemangioma (CCH) is a benign vascular choroidal tumor traditionally characterized on ultrasonography by dome-shaped morphology, acoustic solidity, and high internal reflectivity. Dynamic features on real-time B-scan ultrasonography have not been systematically evaluated. This study aimed to characterize the prevalence of intralesional flickering on real-time dynamic B-scan ultrasonography in treatment-naive CCH and to evaluate its relationship to tumor dimensions and exudative activity.</p> Methods <p>This retrospective observational study included 29 treatment-naive eyes of 29 patients diagnosed with CCH at a tertiary ocular oncology service between 2015 and 2025. Standardized B-scan ultrasonography at 10&#xa0;MHz, with real-time documentation of intralesional flickering, was performed per departmental protocol. Tumor largest basal diameter (LBD) and thickness were measured. Spectral-domain optical coherence tomography was reviewed for subretinal and intraretinal fluid. Associations between flickering status and tumor dimensions, exudative fluid, and tumor location were assessed.</p> Results <p>Mean age was 55.1 years, 75.9% of patients were male, and 65.5% of tumors were macular. Flickering was identified in 17 of 29 eyes (58.6%). Tumors with flickering had a significantly greater largest basal diameter than tumors without flickering (9.27 versus 6.34&#xa0;mm; <i>p</i> &lt; 0.001) and a trend toward greater thickness (3.00 versus 2.21&#xa0;mm; <i>p</i> = 0.073). Fluid on optical coherence tomography was present in 24 eyes (82.8%) and was associated with greater LBD (<i>p</i> = 0.022) and greater tumor thickness (<i>p</i> = 0.027). Fluid was more prevalent in eyes with flickering than in those without flickering (94.1% versus 66.7%; <i>p</i> = 0.130). Tumor location was not significantly associated with flickering status or fluid presence.</p> Conclusions <p>Intralesional flickering on real-time dynamic B-scan ultrasonography is detectable in more than half of treatment-naive CCH and correlates with tumor size, warranting further evaluation as a potential dynamic imaging feature of the lesion.</p> Trial registration <p>Not applicable.</p>

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Intralesional flickering in circumscribed choroidal hemangioma: prevalence and association with tumor size

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Miri Meira Fogel Levin,
  • Abed Elmajed Haj Yahya,
  • Avner Hostovsky,
  • Iris Moroz,
  • Yael Birger,
  • Ido Didi Fabian,
  • Vicktoria Vishnevskia Dai

摘要

Background

Circumscribed choroidal hemangioma (CCH) is a benign vascular choroidal tumor traditionally characterized on ultrasonography by dome-shaped morphology, acoustic solidity, and high internal reflectivity. Dynamic features on real-time B-scan ultrasonography have not been systematically evaluated. This study aimed to characterize the prevalence of intralesional flickering on real-time dynamic B-scan ultrasonography in treatment-naive CCH and to evaluate its relationship to tumor dimensions and exudative activity.

Methods

This retrospective observational study included 29 treatment-naive eyes of 29 patients diagnosed with CCH at a tertiary ocular oncology service between 2015 and 2025. Standardized B-scan ultrasonography at 10 MHz, with real-time documentation of intralesional flickering, was performed per departmental protocol. Tumor largest basal diameter (LBD) and thickness were measured. Spectral-domain optical coherence tomography was reviewed for subretinal and intraretinal fluid. Associations between flickering status and tumor dimensions, exudative fluid, and tumor location were assessed.

Results

Mean age was 55.1 years, 75.9% of patients were male, and 65.5% of tumors were macular. Flickering was identified in 17 of 29 eyes (58.6%). Tumors with flickering had a significantly greater largest basal diameter than tumors without flickering (9.27 versus 6.34 mm; p < 0.001) and a trend toward greater thickness (3.00 versus 2.21 mm; p = 0.073). Fluid on optical coherence tomography was present in 24 eyes (82.8%) and was associated with greater LBD (p = 0.022) and greater tumor thickness (p = 0.027). Fluid was more prevalent in eyes with flickering than in those without flickering (94.1% versus 66.7%; p = 0.130). Tumor location was not significantly associated with flickering status or fluid presence.

Conclusions

Intralesional flickering on real-time dynamic B-scan ultrasonography is detectable in more than half of treatment-naive CCH and correlates with tumor size, warranting further evaluation as a potential dynamic imaging feature of the lesion.

Trial registration

Not applicable.