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E. K. Chin, R. Trikha, L. S. Morse, R. J. Zawadzki, J. S. Werner, S. S. Park; Optical Coherence Tomography Findings of Exophytic Retinal Capillary Hemangiomas of the Posterior Pole. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5238.
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To report the optical coherence tomography (OCT) findings of exophytic retinal capillary hemangiomas (RCH) of the posterior pole and associated macular changes.
Case series of three eyes from two subjects diagnosed with exophytic RCH of the posterior pole imaged with Stratus OCT and/or Fourier-domain optical coherence tomography (Fd-OCT). The Fd-OCT used was either the commercial Cirrus OCT or high resolution Fd-OCT developed at our institution (axial resolution 4 to 4.5 micrometer, transverse resolution 10 to 15 micrometer). One subject was diagnosed with Von Hippel Landau disease and had bilateral posterior pole tumors. The second subject had a solitary peripapillary tumor in one eye which had been misdiagnosed as disc edema previously.
Both Stratus and Fd-OCT showed a well defined lesion contiguous with the outer retina and bulging into the subretinal space in all three eyes. The lesion showed marked shadowing consistent with high flow vascularity. A sharp border was noted between the overlying retina and the tumor in all three eyes. Adjacent cystoid macular edema and subretinal fluid was noted in all eyes. In one eye with a peripapillary tumor, a focal rip of the adjacent photoreceptor layer was visible on high resolution Fd-OCT that extended into the fovea. This eye had no visual recovery after laser treatment of tumor despite complete resolution of the subretinal fluid. Post-operative high resolution Fd-OCT showed diffuse atrophy of the macula with loss of photoreceptor layer.
OCT may be a useful tool in the diagnosis and management of exophytic RCH. The characteristic findings noted by both Stratus and Fd-OCT imaging allow the tumor to be localized to the outer retina and subretinal space. Adjacent morphologic changes in the macula that can affect vision before and after treatment of these tumors can also be assessed using this instrumentation.
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