Optical coherence tomography angiography of iris microhemangiomatosis

Abstract

PurposeTo report optical coherence tomography angiography (OCTA) of iris microhemangiomatosis.ObservationsA 75-year-old asymptomatic Caucasian man was found to have bilateral pupillary vascular lesions during cataract evaluation. Visual acuity was counting fingers in the right eye (OD) and 20/40 in the left eye (OS) with normal intraocular pressures in both eyes (OU). In each eye there were multifocal, round, dark red, pinpoint vascular tufts at the pupillary margin, randomly distributed and numbering 1 in OD and 7 in OS, each measuring 0.2–0.3 mm in diameter and without active bleeding or hyphema. Fundus examination OU was normal. By fluorescein angiography, the multifocal pupillary vascular tufts demonstrated mild staining without leakage. By OCTA, the tufts were clearly delineated and were fed by normal appearing radial iris vessels. OCT b-scan documented the optically dense vascular tufts at 0.1 mm in thickness and angio-overlay confirmed blood flow emanating from the deep iris stroma. Observation was recommended with the option of cataract surgery to improve vision.Conclusions and importanceNon-invasive imaging of iris microhemangiomatosis with OCTA delineates the vascular lesion with flow arising from the posterior iris stroma.

Optical coherence tomography angiography (OCTA) applications in ocular oncology

“…Currently, with the manipulation of offset and manual focus changing, OCTA imaging of the anterior segment is possible with some commercially available retinal devices [ 67 ]. OCTA has revealed that iris microhemangioma is located at the posterior iris stroma and is fed by normal vasculature of the iris [ 68 ].…”

Feasibility of correlation mapping optical coherence tomography angiographic technique using a 200 kHz vertical-cavity surface-emitting laser source for in vivo microcirculation imaging applications

“…However, it is to be noted that very few studies have been carried out to investigate the blood perfusion and vasculature of iris tissue beds compared to retinal angiography. Few studies have been conducted that evaluated the suitability of commercial ophthalmic spectral domain OCT systems during disease conditions such as iris microhemangiomatosis, iris nevus, iris hemangioma [41]- [43], normal iris vasculature [44], in staging neovascularization [45] and in iris tumors [46]. Most of these studies are based on spectral domain systems operating at 70 kHz A-scan rate with an inbuilt SSADA technique.…”

Iris Racemose Hemangioma Assessment with Swept Source Optical Coherence Tomography Angiography: A Feasibility Study and Stand-Alone Comparison

“…AS SD-OCTA has been demonstrated to be a useful and reliable tool for the vascular imaging of both normal irides and benign or malignant lesions of the iris, with possible applications in vascular conjunctival lesions, as well [ 4 , 5 , 9 , 10 , 11 ].…”