Analysis of the characteristics of optical coherence tomography angiography for retinal cavernous hemangioma

Abstract

Rationale:Retinal cavernous hemangioma is a rare congenital vascular malformation with typical fundus changes. Optical coherence tomography angiography (OCTA), which is in rise in the recent years, is a rapid and noninvasive technology to assist in obtaining information regarding the blood flow changes in the fundus lesions from different layers without injecting a contrast agent.Patient concerns:A 40-year-old male patient with visual occlusion in the right eye for >1 month was reported.Diagnoses:Retinal cavernous hemangioma was diagnosed by fundus examination, fluorescein angiography (FA) and OCTA, and the characteristics of OCTA images were analyzed.Interventions:The lesion occurred outside the macula, the central vision remained basically normal, and no significant complications were noted in this patient. Therefore, we preferred to regularly follow-up without therapeutic intervention.Conclusions:OCTA can display fundus blood flow and vascular lesions noninvasively and rapidly. On OCTA, retinal cavernous hemangiomas showed characteristic changes and have good correspondence with fundus imaging and FA examinations. Moreover, OCTA remains more sensitive to vascular abnormalities, and imaging remains clearer, providing new diagnosis and follow-up route for this disease.

A case of retinal cavernous hemangioma analyzed with optical coherence tomography angiography

“…The intensity difference on OCT A illustrates the relative isolation of the blood flow between the tumor and the retinal circulation. [5] Aforementioned OCT A finding of retinal cavernous hemangiomas correlates well with the already known characteristic feature of disease on fundus imaging and FA. Further, the cross-section analysis of OCT b scan and angio overlay showed tumor mass occupying the inner layer of retina and the vitreous traction spanning around its surface [Fig.…”

“…Additionally, small amount of tortuous abnormal branching vessels extends into the lesion which is appreciated as root-like projections of vessels, as noticed in earlier reports. [56] On angio overlay, low flow in the saccular dilated venous system of the angiomatous lesion is demonstrated [Fig. 2c].…”

Exudative Type 3 Retinal Arteriovenous Malformation in a Pediatric Patient

“…FA shows delayed filling during the venous phase without leakage [2]. OCT-A shows a tumor with multiple nodular/grape-like changes, which are moderately reflective [7].…”

Multimodal imaging of a retinal cavernous hemangioma

“…OCTA findings in RCH are described in few reports. 6,7,9,10 OCTA shows characteristic vascular changes of RCH ad has good correspondence with fundus imaging and FFA findings; moreover, OCTA image is less affected by glial fibrosis compared with other imaging examinations. 9 In our case, OCTA confirmed the low flow circulation inside the angiomatous lesions, suggesting the independence between the blood flow inside the lesion from the normal retinal blood flow.…”

“…It has been hypothesized that this superficial membrane causes multiple adhesion tractions leading to retinal tortuosity and dilatation, and even hemorrhagic complications in absence of vitreous detachment. 7 The increased surface gliosis may be consequent to spontaneous thrombosis. 8 The superficial fibroglial component appeared as moderately hyperautofluorescent on FA imaging and it showed mainly a greenish color on MultiColor imaging.…”