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Tânia Borges, Taylor Nayman, Ana Beatriz Toledo Dias, Sultan Aldrees, Beatriz Nugent da Cunha, Miguel N Burnier; Topographic distribution of ocular vascular lesions: a 20-year study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3409.
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The clinical diagnosis of ocular vascular lesions is challenging for ophthalmologists due to similarities between the different categories of these lesions and between them and other non-vascular lesions. The purpose of this study is to describe the clinical and pathological characteristics and the frequency of different ocular vascular lesions in order to assist with differential diagnoses.
We reviewed 15,512 cases diagnosed at the Henry C. Witelson Ocular Pathology Laboratory at McGill University during a 20-year period. Clinical and pathological data of all ocular vascular lesions diagnosed during this period were retrieved. Descriptive analysis of various lesions based on site (eyelid, conjunctiva, and orbit), frequency, gender, and age was performed.
Of the 15,512 specimens reviewed, 115 (0.74%) cases were ocular vascular lesions. Female patients represented approximately half the study population (55.17%). Most patients presented in the 41-60 year age group (42.61%). The most common site of involvement was the eyelid (52.17%), followed by the orbit (27.83%) and conjunctiva (20%). The most common eyelid lesion was capillary hemangioma (36.67%). However, the most common orbit and conjunctiva lesions were cavernous hemangioma (81.25%) and vascular hamartoma (52.17%), respectively. Four malignant lesions were found: Kaposi’s sarcoma (n = 2) and epithelioid hemangioendothelioma (n = 2). Three of these lesions were in the eyelid and one case was conjunctival. One case was misdiagnosed clinically as a benign lesion. Of the 101 cases with clinical diagnoses, 28 cases (27.72%) were misdiagnosed clinically as non-vascular lesions. Encountered lesions include: cavernous hemangioma (38.26%), vascular hamartoma (25.22%), capillary hemangioma (22.61%), lymphangioma (6.96%), vascular ectasia with thrombosis (1.74%), epithelioid hemangioma (0.87%), and intravascular papillary endothelial hyperplasia (0.87%).
The location of ocular vascular lesions is an important feature for differential diagnoses. There was a lack of a correlation between clinical and histopathological diagnosis in one third of cases. The eyelid is the most common site of ocular vascular lesions. Capillary hemangioma is the most common eyelid vascular lesion; however, cavernous hemangioma is the most frequent lesion of all studied sites. Malignant ocular vascular lesions are exceedingly rare.
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