Vision-Threatening Complications of Juxtapapillary Retinal Capillary Hemangioma: A Case of Retinal Artery Occlusion.

Abstract

BACKGROUND Juxtapapillary retinal capillary hemangioma (JRCH) is a rare vascular hamartoma that, when present, can cause many complications. We report a case of branch retinal artery occlusion (BRAO) in the setting of progressive exophytic JRCH, which, to the best of our knowledge, has not been reported until now. CASE REPORT The patient was 34-year-old woman who presented with visual blurring and visual field defects of the left eye and with no significant medical history. Fundoscopy and other auxiliary examinations revealed a red, elevated mass at the optic disc with surrounding hemorrhage and vascular abnormalities. JRCH was then diagnosed, and she underwent conservative treatment. However, 3 days later, during the follow-up, she developed a worsened best corrected visual acuity (BCVA) and visual field defect. The optical coherence tomography angiography found swelling of the tumor, macular edema, and vascular occlusion of the inferior macula; therefore, secondary BRAO was diagnosed. With emergency treatments, the tumor size reduced during the follow-up; however, the vision field, BCVA, and vascular occlusion were not improved. CONCLUSIONS JRCH are rare benign tumors associated with progressive vision loss due to complications such as macular exudate and retinal detachment. Various treatments, including laser, radiotherapy, and anti-angiogenic intravitreal (anti-VEGF) injections, have been suggested; however, the optimal approach is unclear. JRCH complicated with BRAO has not been reported before. Our report suggests that the tumor was closely related to the retinal arteriovenous system, and BRAO could be a vision-threatening complication of JRCH that deserves more attention.