Congenital arteriovenous communications and the development of two types of leaking retinal macroaneurysms

Optical coherence tomography angiography of fleeting macroaneurysm in retinal racemose angioma

We present a rare case of retinal racemose angioma complicated with fleeting macroaneurysm (MA). A 50-year-old female presented with diminution of vision in her right eye for 6 years. Fundus examination showed a racemose angioma with hemorrhagic MA temporal to the fovea in the right eye. On subsequent follow-ups, spontaneous thrombosis of MA was noted with the development of new MA inferior to the fovea, with intraretinal hemorrhage extending into the fovea. Focal laser to MA resulted in resolution of MA with improvement in vision. We report optical coherence tomography angiographic features of the fleeting MA in a case of racemose angioma.

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

Purpose

To 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.

Observations

Congenital 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 importance

RRH 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.

Retinal vein occlusion in retinal racemose hemangioma: a case report and literature review of ocular complications in this rare retinal vascular disorder

Backgroud

Retinal racemose hemangioma (RRH) is a rare congenital disorder that often co-occurs with other ocular complications. In this study, we present a case of RRH complicated with retinal vein obstruction in three branches and provide a review of ocular complications and associations with RRH.

Case presentation

One case of RRH is presented. Fundus examination, fluorescein angiography (FFA) and optical coherence tomography (OCT) of the patient identified Group 3 RRH complicated with retinal vein occlusions in the superotemporal, inferotemporal, and inferonasal branches. Macular edema, which causes visual impairment, was detected. A brief literature review was also presented. The PubMed database was searched for RRH or related keywords to find reports of ocular complications or associations published on or before Dec. 31, 2013. A total of 140 papers describing167 RRH cases were found. The mean age of diagnosis was 22.97 years. Ocular complications were mentioned in 32 (19.16%) cases. Retinal vein occlusion (46.88%) was the major ocular complication in RRH, followed by hemorrhage (34.38%). Eight (4.79%) cases were associated with other ocular diseases such as Sturge–Weber syndrome , Morning glory disc anomaly and macroaneurysm.

Conclusions

Although RRH is a relatively non-progressive condition, its complications may lead to vision loss and should be treated in time.

Temporal branch retinal vein occlusion secondary to a racemose hemangioma

PURPOSE

To describe a case of venous thrombosis secondary to unilateral racemose hemangioma (RH).

METHODS

Biomicroscopic examination, fluorescein angiography, and optical coherence tomography were used. The patient was a 12-year-old girl who was seen for progressive loss of visual acuity in the left eye.

RESULTS

Examination revealed venous thrombosis in the superior temporal vein area in the context of arteriovenous malformation (AVM). Treatment with intravitreal triamcinolone (4 mg) resulted in anatomic and functional improvement.

CONCLUSION

This was an exceptional case of branch retinal vein occlusion secondary to RH in a girl without known risk factors for venous obstruction. The obstruction was attributable to the large-caliber superior temporal artery, which, on forming a loop in the region of the venous branch, produced an obstruction of venous branch blood flow.