Multimodal Imaging in a Case of Localized Suprachoroidal Hemorrhage


Purpose: To report a case of localized suprachoroidal hemorrhage presenting as a choroidal mass.

Case Report: A 66-year-old lady presented with sudden onset pain in the right eye, one week following uneventful cataract surgery. The best corrected visual acuity (BCVA) was 20/160 and fundus examination showed a brown elevated choroidal mass temporal to the fovea in the right eye with normal retina and retinal vessels over it. The differential diagnoses considered were choroidal granuloma, melanoma, choroidal hemangioma, posterior scleritis, and localized suprachoroidal haemorrhage (SCH). Fluorescein angiography (FA) and indocyanine green (ICG) angiography were unremarkable except for mild disc leakage; B-scan showed a choroidal mass with high surface reflectivity and low internal reflectivity, and OCT showed an elevation of retinochoroidal complex with hyporeflective mass in the outer choroid with choroidal folds suggestive of SCH. Her systemic evaluation showed raised ESR and consolidation in the upper lobe of the right lung. The patient did not take any additional treatment for her eye and the lesion regressed and visual acuity improved to 20/30 in one month.

Conclusion: Delayed spontaneous suprachoroidal hemorrhage can present as a choroidal mass. Multimodal imaging helps to differentiate it from other sight-threatening and life-threatening ocular diseases.


Choroidal Granuloma, Choroidal Mass, Melanoma, Supra Choroidal Hemorrhage

1. Marous CL, Sioufi K, Shields CL, Mashayekhi A, Shields JA. Coughing-induced suprachoroidal hemorrhage simulating melanoma in two cases. Retin Cases Brief Rep 2018;12:336–341.

2. Milea D, Fardeau C, Lumbroso L, Similowski T, Lehoang P. Indocyanine green angiography in choroidal tuberculomas. Br J Ophthalmol 1999;83:753.

3. Shields JA, Mashayekhi A, Ra S, Shields CL. Pseudomelanomas of the posterior uveal tract: the 2006 Taylor R. Smith Lecture. Retina 2005;25:767–771.

4. Kahook MY, Noecker RJ. Why do choroidals form, and how do you treat them? Glaucoma Today 2007:36–38.

5. Davison JA. Acute intraoperative suprachoroidal hemorrhage in capsular bag phacoemulsification. J Cataract Refract Surg 1993;19:534–537.

6. Augsburger JJ, Coats TD, Lauritzen K. Localized suprachoroidal hematomas. Ophthalmoscopic features, fluorescein angiography, and clinical course. Arch Ophthalmol 1990;108:968–972.

7. Skalka HW. Choroidal hemorrhage simulating malignant melanoma. J Clin Ultrasound 1982;10:190–192.