Cavernous Hemangioma of the Retina

Noninvasive Structural Imaging of a Retinal Cavernous Hemangioma Using SS-OCTA and Correlation to Previously Reported Histopathology

“…Histopathologic studies suggest this is due to preservation of the blood-retinal barrier by a continuous, non-fenestrated monolayer of normal endothelial cells that form the walls and septa of cavernous hemangiomas. 4 Although OCTA is unable to resolve the vascular endothelium, flow overlay B-scans of our patient give the impression of blood flow only through the lobulated lesion, corresponding to previous histologic images and descriptions by Messmer, et al (Figure 2D). Likewise, aneurysmal dilatations and narrowings have been described via angiography and microscopy, but with SS-OCTA we can noninvasively capture high-resolution images of the hemangioma vasculature en face and adjacent to normal retinal vessels (Figure 2B).…”

Noninvasive Structural Imaging of a Retinal Cavernous Hemangioma Using SS-OCTA and Correlation to Previously Reported Histopathology

“…Histopathologic studies suggest this is due to preservation of the blood-retinal barrier by a continuous, non-fenestrated monolayer of normal endothelial cells that form the walls and septa of cavernous hemangiomas. 4 Although OCTA is unable to resolve the vascular endothelium, flow overlay B-scans of our patient give the impression of blood flow only through the lobulated lesion, corresponding to previous histologic images and descriptions by Messmer, et al (Figure 2D). Likewise, aneurysmal dilatations and narrowings have been described via angiography and microscopy, but with SS-OCTA we can noninvasively capture high-resolution images of the hemangioma vasculature en face and adjacent to normal retinal vessels (Figure 2B).…”

Swept-source Optical Coherence Tomography of Retinal Cavernous Hemangioma: A New Imaging Modality

“…The late frames showed the typical fluid level of “fluorescence capping” within only one saccule (white arrow, Figure 3 ) and this scarcity could be because the angiogram was performed with the patient lying supine; the phenomenon is secondary to the sedimentation of erythrocytes within the venous aneurysm 3. No extravascular leakage of dye is observed in RCH; this is probably due to the presence of a normal blood–retinal barrier in the walls of the hemangioma 8…”

“…RCH frequently has an overlying glial membrane. A previous histopathological study reported the presence of the preretinal membrane containing processes of fibrous astrocytes with cytoplasmic filaments overlying RCH 7,8. The preretinal membrane has been found to be attached to the internal limiting membrane and directly connected to the vascular saccules through breaks in the internal limiting membrane.…”

“…3 No extravascular leakage of dye is observed in RCH; this is probably due to the presence of a normal blood-retinal barrier in the walls of the hemangioma. 8 Previous reports of both time-domain and FD-OCT do not show images from which a diagnosis of RCH can be established without the help of fluorescein angiography. 8 To our knowledge, we are the first to report our diagnostic findings with SS-OCT in a pediatric patient with RCH.…”

“…8 Previous reports of both time-domain and FD-OCT do not show images from which a diagnosis of RCH can be established without the help of fluorescein angiography. 8 To our knowledge, we are the first to report our diagnostic findings with SS-OCT in a pediatric patient with RCH. The high quality and resolution of the images provided by SS-OCT allow for the diagnosis of this condition even in the presence of intraretinal and subretinal hemorrhage and without the need of fluorescein angiography.…”

Noninvasive Structural Imaging of a Retinal Cavernous Hemangioma Using SS-OCTA and Correlation to Previously Reported Histopathology

“…Histopathologic studies suggest this is due to preservation of the blood-retinal barrier by a continuous, non-fenestrated monolayer of normal endothelial cells that form the walls and septa of cavernous hemangiomas. 4 Although OCTA is unable to resolve the vascular endothelium, flow overlay B-scans of our patient give the impression of blood flow only through the lobulated lesion, corresponding to previous histologic images and descriptions by Messmer, et al (Figure 2D). Likewise, aneurysmal dilatations and narrowings have been described via angiography and microscopy, but with SS-OCTA we can noninvasively capture high-resolution images of the hemangioma vasculature en face and adjacent to normal retinal vessels (Figure 2B).…”

Swept-source Optical Coherence Tomography of Retinal Cavernous Hemangioma: A New Imaging Modality

“…The late frames showed the typical fluid level of “fluorescence capping” within only one saccule (white arrow, Figure 3 ) and this scarcity could be because the angiogram was performed with the patient lying supine; the phenomenon is secondary to the sedimentation of erythrocytes within the venous aneurysm 3. No extravascular leakage of dye is observed in RCH; this is probably due to the presence of a normal blood–retinal barrier in the walls of the hemangioma 8…”

“…RCH frequently has an overlying glial membrane. A previous histopathological study reported the presence of the preretinal membrane containing processes of fibrous astrocytes with cytoplasmic filaments overlying RCH 7,8. The preretinal membrane has been found to be attached to the internal limiting membrane and directly connected to the vascular saccules through breaks in the internal limiting membrane.…”

“…3 No extravascular leakage of dye is observed in RCH; this is probably due to the presence of a normal blood-retinal barrier in the walls of the hemangioma. 8 Previous reports of both time-domain and FD-OCT do not show images from which a diagnosis of RCH can be established without the help of fluorescein angiography. 8 To our knowledge, we are the first to report our diagnostic findings with SS-OCT in a pediatric patient with RCH.…”

“…8 Previous reports of both time-domain and FD-OCT do not show images from which a diagnosis of RCH can be established without the help of fluorescein angiography. 8 To our knowledge, we are the first to report our diagnostic findings with SS-OCT in a pediatric patient with RCH. The high quality and resolution of the images provided by SS-OCT allow for the diagnosis of this condition even in the presence of intraretinal and subretinal hemorrhage and without the need of fluorescein angiography.…”

Noninvasive Structural Imaging of a Retinal Cavernous Hemangioma Using SS-OCTA and Correlation to Previously Reported Histopathology

“…Histopathologic studies suggest this is due to preservation of the blood-retinal barrier by a continuous, non-fenestrated monolayer of normal endothelial cells that form the walls and septa of cavernous hemangiomas. 4 Although OCTA is unable to resolve the vascular endothelium, flow overlay B-scans of our patient give the impression of blood flow only through the lobulated lesion, corresponding to previous histologic images and descriptions by Messmer, et al (Figure 2D). Likewise, aneurysmal dilatations and narrowings have been described via angiography and microscopy, but with SS-OCTA we can noninvasively capture high-resolution images of the hemangioma vasculature en face and adjacent to normal retinal vessels (Figure 2B).…”

Swept-source Optical Coherence Tomography of Retinal Cavernous Hemangioma: A New Imaging Modality

“…The late frames showed the typical fluid level of “fluorescence capping” within only one saccule (white arrow, Figure 3 ) and this scarcity could be because the angiogram was performed with the patient lying supine; the phenomenon is secondary to the sedimentation of erythrocytes within the venous aneurysm 3. No extravascular leakage of dye is observed in RCH; this is probably due to the presence of a normal blood–retinal barrier in the walls of the hemangioma 8…”

“…RCH frequently has an overlying glial membrane. A previous histopathological study reported the presence of the preretinal membrane containing processes of fibrous astrocytes with cytoplasmic filaments overlying RCH 7,8. The preretinal membrane has been found to be attached to the internal limiting membrane and directly connected to the vascular saccules through breaks in the internal limiting membrane.…”

“…3 No extravascular leakage of dye is observed in RCH; this is probably due to the presence of a normal blood-retinal barrier in the walls of the hemangioma. 8 Previous reports of both time-domain and FD-OCT do not show images from which a diagnosis of RCH can be established without the help of fluorescein angiography. 8 To our knowledge, we are the first to report our diagnostic findings with SS-OCT in a pediatric patient with RCH.…”

“…8 Previous reports of both time-domain and FD-OCT do not show images from which a diagnosis of RCH can be established without the help of fluorescein angiography. 8 To our knowledge, we are the first to report our diagnostic findings with SS-OCT in a pediatric patient with RCH. The high quality and resolution of the images provided by SS-OCT allow for the diagnosis of this condition even in the presence of intraretinal and subretinal hemorrhage and without the need of fluorescein angiography.…”