Optical Coherence Tomography Angiography of Retinal Cavernous Hemangioma
Diagnosis can be made from characteristic findings on ophthalmoscopy. Fluorescein angiography (FA) has a pseudo-pathognomonic finding of arterial phase hypofluorescence (Figure 1B) and late “capping” of the dye superiorly within the aneurysms. Optical coherence tomography (OCT) of the lesion shows multiloculated cavernous spaces within the retina (Figure 1C). There is commonly an overlying epiretinal membrane.1–5
This condition can occur sporadically or as an autosomal dominantly inherited oculoneurocutaneous syndrome where the condition is associated with central nervous system and cutaneous lesions. Our patient refused neuro-imaging after extensive discussion.
The clinical findings and essential imaging features of retinal cavernous hemangioma have been previously published and are noted above.1–5 We are unaware of previous publication of optical coherence tomography angiography (OCTA) findings in retinal cavernous hemangioma (Figure 1D). Optical coherence tomography angiography is a novel imaging technique which obtains high-resolution visualization of the retinal vasculature. We see that OCTA image delineates the entire lesion in similar potential as the fluorescein angiogram noninvasively, without the use of fluorescein dye. Optical coherence tomography angiography provides dynamic information of the retinal cavernous hemangioma, which is lacking on fluorescein angiography. From the OCTA image, we clearly realize the anatomical dilatation of the retinal cavernous hemangioma with one vein as the main dilated vessel draining the mass (Figure 1D). Moreover, OCTA allows us to adjust segmentation and evaluate the scan in a three dimension (3D) fashion.