03/01/2024
Retinal Cavernous Hemangioma:
▪️Retinal Cavernous Hemangioma is a benign vascular hamartoma, usually sporadic and restricted to the retina or optic nerve head; but can also occur in a familial (autosomal dominant) pattern and may be associated with intracranial and skin hemangiomas.
▪️The lesions are characterized by the formation of grape-like clusters of thin-walled saccular angiomatous lesions in the inner retina or on the optic nerve head.
▪️The blood flow is derived from the retinal circulation and is relatively stagnant, producing a characteristic fluorescein picture. The lesion has no recognized malignant potential.
▪️Some patients also will have small hemangiomas and telangiectasias of the skin or central nerve system.
◼️Ocular manifestations:
➖Generally asymptomatic, unless it involves the macula or bleeds into the vitreous.
➖Most patients tumor is detected on routine ophthalmic examination.
➖Typical appears as a cluster of vascular saccules within the sensory retina in association with retinal vein of anomalous appearance that is neither dilated or tortuous.
◼️Diagnosis:
➖Fluorescein angiography: The dilated saccular lesions fill slowly during angiography and plasma-erythrocyte layering occurs as a result of the sluggish blood flow; leakage is characteristically absent, correlating with the absence of subretinal fluid and exudate, serving to differentiate it from retinal telangiectasia, von Hippel retina angiomatosis and racemose aneurysm of the retina.
◼️Differential Diagnosis:
The only lesions that resemble cavernous hemangioma of retina clinically are the microaneurysmal lesions of idiopathic retinal telangiectasia (Coat´s disease) and Leber multiple retinal arterial aneurysms.
◼️Treatment:
Usually not indicated unless recurrent vitreous hemorrhage develops, in which case photocoagulation or cryotherapy may be effective.
◼️Prognosis:
Most lesions have been observed for prolonged periods of time remain stable in size and clinical appearance. Visual prognosis is good unless the hemangioma involves the macula.
Credit: www.eyewiki.org
