Racemose hemangioma complicated with macular macroaneurysm rupture

• Main Authors: Kodai Yamauchi, Yukihiko Suzuki, Takayuki Tanaka-Gonome, Kobu Adachi, Natsuki Maeda, Mitsuru Nakazawa
• Format: Article
• Language: English
• Published: Elsevier 2021-06-01
• Series: American Journal of Ophthalmology Case Reports
• Subjects: Racemose hemangioma; Macroaneurysm; Vitreous hemorrhage; Vitrectomy; Optical coherence tomography angiography; Silicone oil
• Online Access: http://www.sciencedirect.com/science/article/pii/S245199362100044X

Purpose: To describe a rare case of racemose hemangioma which developed spontaneous macular macroaneurysm (MA) rupture and vitreaous hemorrhage. Observations: A 29-year-old healthy asian female visited our hospital and a racemose hemangioma was found in the left eye. At presentation, the best corrected visual acuity (BCVA) was 30/20 in her left eye. At 9 years after the first visit, MA-like lesion was noted in the macular area. After that, vitreous and subretinal hemorrhage appeared in the left eye. The patient underwent simultaneous vitrectomy and cataract surgery, but vitreous re-hemorrhage occurred two days after the operation. To avoid re-hemorrhage, silicone oil (SO) tamponade was added in the second vitrectomy. Two years after the second operation, SO was removed and postoperative BCVA in the left eye was 20/200 without re-bleeding in the vitreous. Conclusions and Importance: Although retinal hemorrhages have been reported in the patients with a racemose hemangioma, in our case the macular MA rupture occurred at 9 years after the first visit. Congenital retinal arteriovenous anastomosis can show a change in vascular shape in some cases, thus it is important to observe carefully.