Retinal racemose hemangioma with retinal artery macroaneurysm: Optical coherence tomography angiography (OCTA) findings

Abstract

PurposeTo describe a rare case of retinal racemose hemangioma (RRH) with retinal artery macroaneurysm (RAM) and its optical coherence tomography angiography (OCT-A) finding before and after treatment.ObservationsCongenital arteriovenous (AV) communications or RRH is a rare developmental anomaly associated with various ocular conditions. RRH alone is usually asymptomatic, and vision loss occurs when associated with other ocular complications like retinal vein occlusion, hemmorage, macular edema and macroaneurysm. In this communication we describe a case of a 44-year-old female having RRH who presented with active, leaking RAM with subretinal hemmorage. OCT-A through the lesion demonstrated an active aneurysm which on subsequent treatment with anti VEGF and focal laser photocoagulation showed involution of aneurysm.Conclusions and importanceRRH is usually asymptomatic and may be associated with vision threatening ocular complications like RAM. OCT-A helps in giving additional dynamic blood flow information in RAM.

Detection of retinal microvascular changes in von Hippel-Lindau disease using optical coherence tomography angiography

“…[42] In another case report, the OCT-A scan of a retinal racemose hemangioma with retinal artery microaneurysm showed a reduction in flow signal and a decrease in blood flow to the lesion after treatment with focal laser therapy. [43] These findings suggest that a prospective study with OCT-A imaging on RCH eyes without previous laser ablation may give further insight into the application OCT-A in monitoring the development of RCH in VHL patients. RCH lesions are most commonly observed by dilated fundus examination.…”

Exudative Type 3 Retinal Arteriovenous Malformation in a Pediatric Patient

“…It is the second report of OCT-A in Archer type 3. The other case is a 44-year-old female with a combination of type 3 retinal arteriovenous malformation and leaking retinal arterial macroaneurysm successfully treated with anti-vascular endothelial growth factor [4]. OCT-A in type 2 retinal arteriovenous malformation in the left eye of a 46-year-old male has also been published [5].…”

Racemose hemangioma complicated with macular macroaneurysm rupture

“…Recently, optical coherence tomography (OCT) and OCT angiography (OCTA) have been shown useful as multimodal imaging modalities for diagnosis. 11 , 16 An MA in racemose hemangioma cases can be observed with OCTA. 11 Cases of macular edema due to a racemose hemangioma have been treated with intra-vitreous injection of anti-vascular endothelial growth factor.…”

“… 11 , 16 An MA in racemose hemangioma cases can be observed with OCTA. 11 Cases of macular edema due to a racemose hemangioma have been treated with intra-vitreous injection of anti-vascular endothelial growth factor. 9 , 17 , 18 Additionally, some cases that showed spontaneous regression of dilated vessels within a few months or years have also been reported.…”

“…Although some racemose hemangioma cases have no symptom, 3 others have been reported to be complicated by retinal, vitreous, or subretinal hemorrhage, 4 , 5 central retinal vein occlusion (CRVO) or CRVO-like retinal hemorrhage, 6 , 7 , 8 , 9 a retinal MA in the macula, 10 , 11 macular ischemia without retinal neovascularization or iris rubeosis, 12 or extensive retinal ischemia resulting in rubeotic glaucoma. 13 , 14 Soliman reported a case of bilateral racemose hemangioma complicated with macular edema or exudation.…”