Multimodal imaging in cavernous hemangioma
Maryam Dourandeesh Langroudy1 *, Yousef Alizadeh1
- Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Abstract: Retinal cavernous hemangioma is a rare vascular tumor that is typically diagnosed on routine examination. (1) it can be associated with cerebral and cutaneous angioma.(2) Typical fundus findings are clumps of grapelike thin-walled saccular angiomatous lesions in the inner retina or on the optic nerve head. Commonly, there is overlying, white, fibroglial tissue on the mass.(3) It is usually asymptomatic but Complications such as hemorrhage, retinal arterial occlusions, or compressive damage to retinal nerve fibers may occur in rare cases.(4) Imaging techniques such as spectral-domain optical coherence tomography (SD-OCT) or fluorescein angiography (FA) can be used in the diagnosis.(5)
Here, we present a large optic nerve head hemangioma in a 7-year-old girl discovered in a routine eye examination
Methods: A 7-year-old girl with unremarkable medical and ocular history presented to our clinic for a routine eye examination. The best-corrected visual acuity (BCVA) of the right eye was 20/20 and the left eye was finger count 3m. Slit-lamp examination of both eyes was unremarkable, and intraocular pressure of each eye was 15 mm Hg. Fundus examination of the left eye revealed dark red “cluster of grapes” appearance of cavernous hemangioma on the optic nerve extending to the macula with overlying, white, fibroglial tissue (Figure 1). Fundus examination of the right eye was normal. Fluorescein angiography of the left eye disclosed late “capping” of the dye superiorly within the aneurysms owing to the pooling of dye within the overlying plasma (Figure 2). Spectral-domain optical coherence tomography (SD-OCT) of the left eye showed multiloculated cavernous spaces within the retina separated by thin septa. (Figure 3) The patient was not cooperative for optical coherence tomography angiography (OCTA).
Results: Figure 1-3
Conclusion: Our case highlights the imaging finding (including SD-OCT and fluorescein angiography) in a young girl with cavernous hemangioma of the optic nerve head. These imaging modalities can be used in the diagnosis of vascular lesions of the retina and optic nerve and diagnosis of etiology of vision loss in such cases.
