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Ophthalmic Images
December 10, 2020

Retinal Cavernous Hemangioma With Multiple Saccules Not Filled With Blood

Author Affiliations
  • 1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
  • 2Retinal Degeneration Research Laboratory, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
JAMA Ophthalmol. 2020;138(12):e202298. doi:10.1001/jamaophthalmol.2020.2298

In 2006, a 65-year-old woman presented with a mass in the nasal retina the size of 1.5 optic-disc diameters, composed of about 10 yellowish saccules of various sizes surrounded by multiple small, aneurysmal lesions (Figure, A). The saccular lesions were not filled with obvious blood. A late-phase fluorescein angiography image showed incomplete perfusion of the surrounding aneurysmal lesions, likely because of plasma-erythrocyte separation, but this was not found within the main saccular lesions (Figure, B). A diagnosis of retinal cavernous hemangioma was made, and the lesion showed no change during 13-year follow-up. Recent Spectral domain optical coherence tomography in 2019 demonstrated hyperreflective and hyporeflective signals attributable to erythroclastic layering within the cystoid spaces in the inner retina (Figure, A).

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