1
|
Barros LL, Lima PLGDSB, de Oliveira Júnior PH, Dias DA, Santos CDF, Braga-Neto P, Nóbrega PR. Peculiar aetiology for orbital apex syndrome: Wyburn-Mason syndrome as orbital apex lesion. BMJ Neurol Open 2024; 6:e000559. [PMID: 38268749 PMCID: PMC10806852 DOI: 10.1136/bmjno-2023-000559] [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: 11/12/2023] [Indexed: 01/26/2024] Open
Abstract
Background Wyburn-Mason syndrome is a rare, non-hereditary congenital disease, belonging to the group of neurocutaneous syndromes with fewer than 100 cases reported since its first description in 1937. Case report A young adult man was initially evaluated at the age of 2 years for proptosis and progressive visual impairment of the right eye, followed by impairment in ocular abduction, adduction and elevation as well as amaurosis. MRI revealed an expansive formation centred in the right orbit compromising conal spaces with distortion of eye muscles and optic nerve. The lesion extended through the superior orbital fissure into the right cavernous sinus and to the contralateral orbit. Despite embolisation, proptosis and oedema of the periorbital tissue continued to worsen. The combination of facial, ocular and intracranial vascular malformations and the exclusion of alternative aetiologies led to a diagnosis of cerebrofacial arteriovenous metameric syndrome (CAMS) 1 (Wyburn-Mason syndrome). Discussion Important differential diagnoses are other CAMS, such as Sturge-Weber syndrome, as well as other conditions such as retinal cavernous haemangioma and vasoproliferative tumours. The optimal treatment regimen for severe cases of this syndrome is still unclear. Wyburn-Mason syndrome should be considered in patients presenting multiple arteriovenous malformations with orbital apex lesions.
Collapse
Affiliation(s)
| | | | | | | | | | - Pedro Braga-Neto
- State University of Ceara, Fortaleza, Brazil
- Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Brazil
| | - Paulo Ribeiro Nóbrega
- Division of Neurology, Federal University of Ceara, Fortaleza, Brazil
- Centro Universitário Christus, Fortaleza, Brazil
| |
Collapse
|
2
|
Choo CH, Tsui I, Homer RJ, Suh SY. Ultrawide Field Imaging of Progressive Retinal Arteriovenous Malformation in a Pediatric Patient with Wyburn-Mason Syndrome. Ophthalmic Surg Lasers Imaging Retina 2022; 53:46-48. [PMID: 34982002 DOI: 10.3928/23258160-20211210-02] [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: 11/20/2022]
Abstract
Wyburn-Mason syndrome (WMS) is a rare congenital disease that presents with unilateral arteriovenous malformation (AVM) in the visual pathway, midbrain, and/or skin. We report a case of a 5-year-old girl with a history of cerebral and orbital AVM who presented with left exotropia and was found to have group 3 retinal AVM consistent with WMS. Here, we use ultrawide field imaging to show the progression of retinal AVM and peripheral nonperfusion areas for a period of 1 year in a pediatric patient with WMS. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:46-48.].
Collapse
|
3
|
Piria R, Rommel F, Zimbelmann M, Erikson K, Babst N, Brosig A, Freitag JC, Ranjbar M, Grisanti S, Kakkassery V. [Retinal tumors in adults - Part 1: vascular tumors of the retina]. Ophthalmologe 2021; 118:1057-1062. [PMID: 34309716 DOI: 10.1007/s00347-021-01445-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/10/2021] [Accepted: 06/08/2021] [Indexed: 10/20/2022]
Abstract
Retinal tumors are a heterogeneous group of congenital and acquired lesions. In this review series the important retinal tumors are discussed and presented in two articles. In the first part of the article the most important vascular tumors of the retina are presented. Even with benign tumors visual symptoms, such as exudative retinal detachment occur, which often lead to irreversible visual impairments. Because visual symptoms are often a manifestation of systemic diseases, the ophthalmologist plays an important role in the accurate and early diagnosis of retinal tumors. This article reviews the most important clinical and diagnostic features of retinal vascular tumors in adults, their systemic associations and the literature on currently available treatment strategies.
Collapse
Affiliation(s)
- Roya Piria
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
| | - Felix Rommel
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Michael Zimbelmann
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Kristina Erikson
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Neele Babst
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Anton Brosig
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Josephine Christin Freitag
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Mahdy Ranjbar
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Salvatore Grisanti
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Vinodh Kakkassery
- Klink für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| |
Collapse
|
4
|
Yamauchi K, Suzuki Y, Tanaka-Gonome T, Adachi K, Maeda N, Nakazawa M. Racemose hemangioma complicated with macular macroaneurysm rupture. Am J Ophthalmol Case Rep 2021; 22:101053. [PMID: 33786403 PMCID: PMC7994723 DOI: 10.1016/j.ajoc.2021.101053] [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: 08/21/2020] [Revised: 10/29/2020] [Accepted: 02/21/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To describe a rare case of racemose hemangioma which developed spontaneous macular macroaneurysm (MA) rupture and vitreaous hemorrhage. Observations A 29-year-old healthy asian female visited our hospital and a racemose hemangioma was found in the left eye. At presentation, the best corrected visual acuity (BCVA) was 30/20 in her left eye. At 9 years after the first visit, MA-like lesion was noted in the macular area. After that, vitreous and subretinal hemorrhage appeared in the left eye. The patient underwent simultaneous vitrectomy and cataract surgery, but vitreous re-hemorrhage occurred two days after the operation. To avoid re-hemorrhage, silicone oil (SO) tamponade was added in the second vitrectomy. Two years after the second operation, SO was removed and postoperative BCVA in the left eye was 20/200 without re-bleeding in the vitreous. Conclusions and Importance Although retinal hemorrhages have been reported in the patients with a racemose hemangioma, in our case the macular MA rupture occurred at 9 years after the first visit. Congenital retinal arteriovenous anastomosis can show a change in vascular shape in some cases, thus it is important to observe carefully.
Collapse
|
5
|
The Natural History of Retinal Vascular Changes from Infancy to Adulthood in Wyburn-Mason Syndrome. Medicina (B Aires) 2020; 56:medicina56110598. [PMID: 33182356 PMCID: PMC7695326 DOI: 10.3390/medicina56110598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 11/20/2022] Open
Abstract
Wyburn-Mason syndrome is a rare, non-hereditary congenital neurocutaneous disorder leading to arteriovenous malformations. Malformations are characterized by an artery that is directly connected to veins without a capillary system and forms a fragile mass of abnormal vessels. It can be found in the midbrain, in the eyes, orbit, and rarely in cutaneous nevi. Neurological and ocular symptoms are the most common. Ocular signs and symptoms include abnormally dilatated vessels of conjunctiva, nystagmus, strabismus, vitreous hemorrhage, vein occlusions, retinal detachment, etc. Neurological symptoms may include headaches, paralysis, epistaxis, hydrocephalus, and hemiparesis. Imaging modalities such as MRI/CT angiography, optical coherence angiography, and fluorescein angiography are the most important for the identification of arteriovenous malformations. In our case report, we present an eight-month-old girl with an incidental finding of retinal angiomatosis on the left eye and was subsequently diagnosed with Wyburn-Mason syndrome. We compare the findings from the first visit to her clinical findings 20 years later.
Collapse
|
6
|
Karti O, Top Karti D, Ayhan Z, Celebisoy N, Saatci AO. Bilateral Congenital Prepapillary Retinal Arterial Loop. Neuroophthalmology 2020; 44:344-348. [PMID: 33012926 DOI: 10.1080/01658107.2019.1680704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Prepapillary vascular loops are rare congenital vascular abnormalities of the retinal vasculature. This mostly benign condition can sometimes cause complications such as branch retinal artery occlusion and vitreous haemorrhage. Disc collaterals, neovascularisation of the optic disc, idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome and Wyburn Mason syndrome should be kept in mind for the vascular differential diagnosis. In addition, when the loops present bilaterally and settle into the region adjacent to the optic disc border, they can be misdiagnosed as papilloedema. The diagnosis is usually made clinically by careful fundus examination. Optical coherence tomography and fundus fluorescein angiography might serve as ancillary tools for the diagnosis. In this report, we present a 52-year-old male with bilateral prepapillary arterial loops referred to our clinic with a preliminary diagnosis of papilloedema.
Collapse
Affiliation(s)
- Omer Karti
- Department of Ophthalmology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Dilek Top Karti
- Department of Neurology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ziya Ayhan
- Department of Ophthalmology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| | - Nese Celebisoy
- Department of Neurology, Ege University Medical Faculty, Izmir, Turkey
| | - Ali Osman Saatci
- Department of Ophthalmology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| |
Collapse
|
7
|
Retinal manifestations of the neurocutaneous disorders. Curr Opin Ophthalmol 2020; 31:549-562. [PMID: 33009088 DOI: 10.1097/icu.0000000000000712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE OF REVIEW The neurocutaneous disorders are a genetically and phenotypically diverse group of congenital syndromes characterized by cutaneous, ocular, and central nervous system manifestations. This review provides an overview of the clinical features and retinal findings in selected neurocutaneous disorders. RECENT FINDINGS Advances in genetics and diagnostic retinal and neuroimaging allow for the recognition of retinal features of common neurocutaneous syndromes and for improved characterization of rarer entities based on previously underdiagnosed or unrecognized retinal findings. SUMMARY Better characterization of the neurocutaneous disorders allows for earlier recognition and the potential for expeditious vision-saving and life-saving treatment.
Collapse
|