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Carreira P, Ferreira M, Brízido M, Cabral D. Macular shunt in radiation retinopathy. Am J Ophthalmol Case Rep 2024; 34:102019. [PMID: 38433978 PMCID: PMC10904919 DOI: 10.1016/j.ajoc.2024.102019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/27/2024] [Accepted: 02/14/2024] [Indexed: 03/05/2024] Open
Affiliation(s)
| | | | | | - Diogo Cabral
- Hospital Garcia de Orta, Almada, Portugal
- iNOVA4Health, NOVA Medical School, Universidade NOVA de Lisboa, Portugal
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Ahmad Tarmizi NN, Bastion MLC, Abdul Aziz RA, Md Din N, Mohd Khialdin S. Retinal Racemose Hemangioma With Optic Neuropathy in a Child. Cureus 2021; 13:e17620. [PMID: 34646671 PMCID: PMC8483998 DOI: 10.7759/cureus.17620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 12/01/2022] Open
Abstract
The aim of this study is to report an unusual case of retinal racemose haemangioma (RRH) in a child resulting in optic neuropathy and its optical coherence tomography angiography (OCT-A) findings. This is a retrospective case report. For almost a year, a 13-year-old girl experienced gradual, painless, generalized blurred vision in her right eye. Visual acuity was 6/60 with a positive relative afferent pupillary defect (RAPD) in her right eye. The right-eye fundus showed enlarged and tortuous retinal vessels extending from the optic disc to all four quadrants, including the juxta foveal region. OCT analysis revealed distortion in the region of enlarged vessels with minimal retinal fluid while OCT-A of the macula area demonstrated dilated and tortuous vessels in the superficial layers of the retina. Right intra-orbital vascular channels surrounding the optic nerve with optic nerve atrophy and gliosis were detected on magnetic resonance imaging angiography/venography (MRA/MRV). The cerebral angiogram reported an abnormal tangle of small vessels within the right orbit that received supply from a dilated right ophthalmic artery indicating the presence of retro-orbital arteriovenous malformation (AVM). She was then referred to the neurosurgeon and a decision was made not to embolize or resect the dilated vessel as this might lead to occlusion of the ophthalmic artery and thus worsen her vision. RRH may present in the paediatric age group, and optic nerve atrophy is one of the disease manifestations. OCT-A is a less invasive diagnostic option compared to fundus fluorescein angiography (FFA) for diagnosis and monitoring of disease progression.
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Affiliation(s)
| | - Mae-Lynn Catherine Bastion
- Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.,Ophthalmology, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | | | - Norshamsiah Md Din
- Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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Cohen SY, Nghiem-Buffet S. Pre- and juxtapapillary arterial loops in eyes with tilted disc syndrome and inferior staphyloma. Am J Ophthalmol Case Rep 2021; 24:101194. [PMID: 34485757 PMCID: PMC8405914 DOI: 10.1016/j.ajoc.2021.101194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/09/2021] [Accepted: 08/23/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose To report and discuss the association between pre- or juxtapapillary arterial loops and tilted disc syndrome (TDS). Observations Three patients, aged 43–59 years, with both conditions were examined in a tertiary referral center, and underwent fluorescein angiography, optical coherence tomography (OCT) and/or OCT-angiography. They all presented with a typical inferior staphyloma associated with TDS and anomalies of insertion of retinal vessels. The vascular malformation consisted in one acquired arterial loop or cilioretinal collateral circulation occurring after central artery occlusion, and two more complex pre- and juxtapapillary arterial loops. In all cases, the vascular loops extended inferiorly, in the area of the staphyloma. Conclusion and importance We hypothesized that the local anatomical changes in the peripapillary area, observed in eyes with TDS and inferior staphyloma, could have promoted the occurrence and/or extent of the arterial loops.
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Affiliation(s)
- Salomon Yves Cohen
- Ophthalmology Center for Imaging and Laser, University of Paris-Sorbonne, Paris, France.,Department of Ophthalmology, University of Paris Est, University of Paris-Sorbonne, Creteil, France
| | - Sylvia Nghiem-Buffet
- Ophthalmology Center for Imaging and Laser, University of Paris-Sorbonne, Paris, France.,Department of Ophthalmology, Avicenne Hospital, AP-HP, University of Paris-Sorbonne, France
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Battista M, Cicinelli MV, Lattanzio R, Bandello F. Retinal Arteriovenous Malformation Occlusion and Optic Nerve Drusen: Casuality or Causality? Ophthalmic Surg Lasers Imaging Retina 2020; 51:418-419. [PMID: 32706901 DOI: 10.3928/23258160-20200702-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/08/2020] [Indexed: 11/20/2022]
Abstract
Multimodal imaging of an impending retinal vein occlusion in an arteriovenous malformation associated with optic nerve drusen (OND) in a 16-year-old girl affected by Wyburn-Mason Syndrome. The authors seek to determine whether the association between the two entities has had an additive role in the acute retinal vascular event. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:418-419.].
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Prepapillary vascular loop-a new classification. Eye (Lond) 2020; 35:425-432. [PMID: 32291404 DOI: 10.1038/s41433-020-0859-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES To analyze the ophthalmic characteristics of congenital prepapillary vascular loop (PVL) and to propose a new morphologic classification dividing the loops into six types. SUBJECTS/METHODS Collaborative multinational multicentre retrospective study of PVL cases. RESULTS There was a total of 49 cases (61 eyes), 37 unilateral (75.5%) and 12 bilateral (24.5%), 32 arterial type (65.3%) and 18 venous type (36.7%) (one patient had either kind in each eye). The mean number of loops per eye was 2.7 (range, 1-7). The loops were asymptomatic in 42 cases (85.7%). Other findings included: the presence of cilioretinal artery (14 cases), retinal vascular tortuosity (26 cases), amaurosis fugax (1 case), branch retinal artery occlusion (1 case) and vitreous haemorrhage (3 cases). Six morphologic loop types could be discerned based on elevation (flat vs. elevated), shape (figure of 8 or corkscrew with hyaline sheath), number (multiple or single), location (central or peripheral), lumen size (arterial vs. arteriolar) and presence of vascular tortuosity or vitreous traction. CONCLUSIONS PVL are usually asymptomatic and can be divided into six morphologic types with different pathogenesis during early embryogenesis.
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Capuano V, Oliverio L, Amoroso F, Srour M, Souied EH, Querques G. Appearance of macular edema during pregnancy due to retinal arteriovenous malformation. J Fr Ophtalmol 2018; 41:e383-e385. [PMID: 30172380 DOI: 10.1016/j.jfo.2017.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 11/16/2017] [Indexed: 11/25/2022]
Affiliation(s)
- V Capuano
- Department of ophthalmology, centre hospitalier intercommunal de Créteil University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
| | - L Oliverio
- Department of ophthalmology, centre hospitalier intercommunal de Créteil University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
| | - F Amoroso
- Department of ophthalmology, centre hospitalier intercommunal de Créteil University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
| | - M Srour
- Department of ophthalmology, centre hospitalier intercommunal de Créteil University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
| | - E H Souied
- Department of ophthalmology, centre hospitalier intercommunal de Créteil University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
| | - G Querques
- Department of ophthalmology, centre hospitalier intercommunal de Créteil University Paris Est, 40, avenue de Verdun, 94000 Créteil, France; Department of ophthalmology, IRCCS Ospedale San Raffaele, university Vita-Salute, Milan, Italy.
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Retinal racemose hemangioma with retinal artery macroaneurysm: Optical coherence tomography angiography (OCTA) findings. Am J Ophthalmol Case Rep 2018; 11:98-100. [PMID: 29998207 PMCID: PMC6038827 DOI: 10.1016/j.ajoc.2018.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/08/2018] [Accepted: 06/19/2018] [Indexed: 11/23/2022] Open
Abstract
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.
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Rouatbi A, Chebbi A, Bouguila H. Management of capillary non-perfusion associated with retinal racemose hemangioma. J Fr Ophtalmol 2018; 41:e219-e224. [PMID: 29779932 DOI: 10.1016/j.jfo.2017.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/18/2017] [Accepted: 09/25/2017] [Indexed: 11/27/2022]
Affiliation(s)
- A Rouatbi
- National Institute of Ophthalmology, Tunisia University of Tunis El Manar, Faculty of Medicine of Tunis (FMT), 1053 Tunis, Tunisia.
| | - A Chebbi
- National Institute of Ophthalmology, Tunisia University of Tunis El Manar, Faculty of Medicine of Tunis (FMT), 1053 Tunis, Tunisia
| | - H Bouguila
- National Institute of Ophthalmology, Tunisia University of Tunis El Manar, Faculty of Medicine of Tunis (FMT), 1053 Tunis, Tunisia
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Capuano V, Miere A, Amoroso F, Todisco L, Cohen SY, Souied E, Querques G. Uncommon retinal vascular diseases. EXPERT REVIEW OF OPHTHALMOLOGY 2016. [DOI: 10.1080/17469899.2016.1251315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
PURPOSE To report a case of racemose hemangioma with macular involvement and treated with anti-vascular endothelial growth factor. METHODS Observational case report. RESULTS JFS, a 31-year-old woman, presented with a complaint of blurred vision in her right eye over the preceding 2 months, worsening during the previous month. An examination conducted in May 2013 showed visual acuity of 20/30 in her right eye and 20/20 in her left eye, deteriorating to 20/40 in the right eye 1 month later. Retinography of the right eye revealed a dilated tortuous retinal vessel in the lower temporal arcade, affecting the macular region. Because of progressive deterioration in the patient's visual acuity, she was treated with 3 intravitreal bevacizumab injections, with an interval of 1 month between them. At the end of the proposed treatment, the patient was followed up on an outpatient basis for 12 months, with visual acuity of 20/20 in both eyes and no signs of retinal exudation throughout the entire follow-up period. CONCLUSION Racemose hemangioma with focal macular involvement may lead to a progressive reduction in visual acuity because of exudation. Further studies need to be conducted to confirm the efficacy of bevacizumab injections to treat vascular malformation; however, this form of management does seem promising.
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Sharma P, Sridhar J, Rayess N, Maguire JI. Optical coherence tomography angiography (OCT-A) of type 2 retinal arteriovenous malformation. Can J Ophthalmol 2015; 50:e93-6. [DOI: 10.1016/j.jcjo.2015.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 05/06/2015] [Accepted: 06/03/2015] [Indexed: 11/28/2022]
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Qin XJ, Huang C, Lai K. Retinal vein occlusion in retinal racemose hemangioma: a case report and literature review of ocular complications in this rare retinal vascular disorder. BMC Ophthalmol 2014; 14:101. [PMID: 25142779 PMCID: PMC4149677 DOI: 10.1186/1471-2415-14-101] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 08/08/2014] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Xue-jiao Qin
- Department of Ophthalmology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Box 639, Shandong PRC 250012, China.
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Rouvas A, Petrou P, Ladas I, Vergados I, Andipa ES, Papathanasiou M, Markomichelakis N. Extensive unilateral visual field loss due to peripapillary arteriovenous malformation. Int Ophthalmol 2011; 31:135-9. [DOI: 10.1007/s10792-011-9426-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2009] [Accepted: 01/01/2011] [Indexed: 11/24/2022]
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Woo YJ, Lee YH, Yoon IN. A Case Report of Bilateral Retinal Racemose Hemangioma Restricted to Peripapillary Area. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2011. [DOI: 10.3341/jkos.2011.52.11.1381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Young Jun Woo
- Department of Ophthalmology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yoon Ha Lee
- Department of Ophthalmology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ie Na Yoon
- Department of Ophthalmology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
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Abstract
PURPOSE To review recent advances in the diagnosis and treatment of congenital vascular malformations of the retina and choroid. METHODS Review of the current literature on retinal haemangioblastoma, racemose haemangiomatosis, retinal cavernous haemangioblastoma, circumscribed choroidal haemangioma, and diffuse choroidal haemangioma. CONCLUSION The management of patients with congenital vascular lesions of the retina and choroid is advancing rapidly through recent developments in genetic testing, ocular imaging, and treatment. Most are associated with systemic disease, which may be life-threatening. New therapeutic methods such as Verteporfin photodynamic therapy and anti-angiogenic therapy have significantly improved the treatment of retinal and choroidal angiomas and vascular malformations. Ophthalmologists have a major role in detecting and diagnosing these tumours and in providing long-term care in collaboration with a specialist in the field.
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Schmidt D, Pache M, Schumacher M. The congenital unilateral retinocephalic vascular malformation syndrome (bonnet-dechaume-blanc syndrome or wyburn-mason syndrome): review of the literature. Surv Ophthalmol 2008; 53:227-49. [PMID: 18501269 DOI: 10.1016/j.survophthal.2007.10.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Retinal arteriovenous malformations represent a rare syndrome in which a direct connection of major vessels without interposition of capillaries may lead to various complications such as thrombosis and vessel occlusion. This review comprises the computer-stored data of all the 121 patients with arteriovenous malformations described in the literature. Twenty-seven patients had typical Bonnet-Dechaume-Blanc syndrome (in this article designated as congenital retinocephalofacial vascular malformation syndrome), 25 had incomplete congenital retinocephalofacial vascular malformation syndrome (without facial skin lesions), 57 had isolated retinal arteriovenous malformations, and 12 had arteriovenous communications of the retina and distinct neurological signs, but without neuroradiological evidence of cerebral arteriovenous malformations (presumed cerebral arteriovenous malformations). Concerning the retinal findings, we found a distinct difference by comparing patients with congenital retinocephalofacial vascular malformation syndrome and those with isolated retinopathy without cerebral or facial malformations: extensive retinal malformations of vessels of most parts of the fundus occurred conspicuously more often in patients with retinal and cerebral arteriovenous malformations. In contrast, local retinal arteriovenous malformations occurred in all patients with isolated retinopathy without cerebral or facial malformations and rarely in patients with congenital retinocephalofacial vascular malformation syndrome. In conclusion, patients with arteriovenous communications of the retina should be examined early with brain and orbital neuroimaging to rule out cerebral arteriovenous malformations. Current therapeutic strategies include endovascular, surgical, and radiation procedures.
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Affiliation(s)
- Dieter Schmidt
- Department of Ophthalmology, University Freiburg, Freiburg, Germany
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Soliman W, Haamann P, Larsen M. Exudation, response to photocoagulation and spontaneous remission in a case of bilateral racemose haemangioma. ACTA ACUST UNITED AC 2006; 84:429-31. [PMID: 16704713 DOI: 10.1111/j.1600-0420.2005.00644.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Wael Soliman
- Department of Ophthalmology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
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Chatterjee S, Hope-Ross M, Clark IH, Chell PB. A rare and unusual congenital arteriovenous communication of the retina. Eye (Lond) 2004; 18:74-5. [PMID: 14707971 DOI: 10.1038/sj.eye.6700375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Shah GK, Shields JA, Lanning RC. Branch retinal vein obstruction secondary to retinal arteriovenous communication. Am J Ophthalmol 1998; 126:446-8. [PMID: 9744380 DOI: 10.1016/s0002-9394(98)00103-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To document a branch retinal vein obstruction secondary to a congenital arteriovenous communication. METHOD Case report of a young patient with retinal arteriovenous communication. RESULTS A 12-year-old girl had a grade 2 retinal arteriovenous communication in her right eye. She was asymptomatic and was subsequently followed up. Magnetic resonance imaging of the brain was normal and disclosed no signs of Wyburn-Mason syndrome. Nine years later, she developed a branch retinal vein obstruction in the area of the arteriovenous communication. Six months later, the patient was free of secondary complications of branch retinal vein obstruction; however, she is being followed up to detect any retinal or iris neovascularization. CONCLUSION Awareness of retinal vascular obstruction associated with arteriovenous communication may help its timely recognition, as well as prompt treatment of potential complications, such as retinal and iris neovascularization.
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Affiliation(s)
- G K Shah
- Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Abu el-Asrar AM, Kahtani ES, Tabbara KF. Retinal arteriovenous communication in retinitis pigmentosa with Refsum's disease-like findings. Doc Ophthalmol 1995; 89:313-20. [PMID: 7493533 DOI: 10.1007/bf01203707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In this report we describe, herewith, a patient with primary pigmentary dystrophy of the retina (retinitis pigmentosa) associated with unilateral retinal arteriovenous communication and exudative retinal detachment. The patient had complete resolution of the retinal detachment following laser photocoagulation treatment. Such association has not been previously reported.
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Affiliation(s)
- A M Abu el-Asrar
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Winterkorn JM. Peripapillary hemorrhage. Surv Ophthalmol 1993; 37:362-72. [PMID: 8484169 DOI: 10.1016/0039-6257(93)90066-g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
On routine examination, a 61-year-old man was found to have a deep peripapillary hemorrhage surrounding his left optic nerve head. Further examination revealed a left sixth nerve paresis, a subtle right homonymous quadrantanopia, and jerky pursuit to the left. The diagnostic work-up was delayed by the patient because of business commitments. He returned confused and obtunded. Neuro-imaging showed a large frontal mass, which turned out to be an anaplastic astrocytoma. Diagnosis of the lesion had been obscured by three false localizing signs. Discussion deals with the definition of Terson's syndrome and the occurrence of peripapillary hemorrhages. Other causes of peripapillary hemorrhages are illustrated.
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Affiliation(s)
- J M Winterkorn
- Department of Ophthalmology, North Shore University Hospital-Cornell University Medical College, Manhasset, New York
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Schatz H, Chang LF, Ober RR, McDonald HR, Johnson RN. Central retinal vein occlusion associated with retinal arteriovenous malformation. Ophthalmology 1993; 100:24-30. [PMID: 8433820 DOI: 10.1016/s0161-6420(93)31701-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
PURPOSE/BACKGROUND Retinal arteriovenous malformations can be seen in a variety of ways and have multiple, associated, ocular changes that can affect vision. The authors report two cases of retinal arteriovenous malformation. In each case, a central retinal vein occlusion developed. METHODS Each patient underwent clinical examination and fluorescein angiography. One patient was followed over a long period of time. CONCLUSION The authors propose that a turbulent flow, high intravascular volume, and arteriolar pressure in the venous side of the retinal arteriovenous malformation may lead to vessel wall damage, thrombosis, and occlusion. They also suggest that compression of the central retinal vein by the mass effect of the arteriovenous malformation on the optic nerve further leads to turbulence and thrombosis.
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De Jong PT. Neovascular glaucoma and the occurrence of twin vessels in congenital arteriovenous communications of the retina. Doc Ophthalmol 1988; 68:205-12. [PMID: 2456906 DOI: 10.1007/bf00156427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Two cases with unilateral congenital arteriovenous communications of the retina are described. One of them developed a neovascular glaucoma. Both cases had twin vessels of the retina. The possible significance of twin vessels in these cases is discussed.
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Affiliation(s)
- P T De Jong
- Department of Ophthalmology, Erasmus University Rotterdam, Eye Hospital, the Netherlands
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Abstract
The authors followed up on a series of 24 eyes in 12 patients with Takayasu disease in its moderate to advanced stage over the past 10 years. They paid particular attention to arteriovenous shunt formation in the retina. The authors could identify two types of arteriovenous shunts based on rapid sequence fluorescein angiography. In six eyes, arteriovenous shunts had formed at arteriovenous crossings through direct communication of arterial and venous lumen in the midperipheral retina. In 22 eyes, arteriovenous shunts had formed consequent to dilation of capillaries, formation of preferential channels, and obliteration of neighboring capillaries. These two types seemed to be basic patterns of discrete arteriovenous shunts that characterize Takayasu disease in its advanced stage.
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Affiliation(s)
- T Tanaka
- Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan
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