Angiomatous Tumors

Question 1

two types of choroidal hemangiomas and their associations

Answer 1

circumscribed: benign, in otherwise healthy individuals. can cause RD and cystoid degeneration of outer retina
diffuse: Sturge-Weber, involve entire retina (tomato ketchup fundus), RD and glaucoma are common

Question 2

ultrasound differences between choroidal hemangiomas and choroidal melanomas

Answer 2

high internal reflectivity for hemangioma, low internal reflectivity for melanoma

Question 3

primary treatment for serous RD associated with choroidal hemangioma. alternative?

Answer 3

PDT (recently replaced laser photcoagulation). brachytherapy can also be used

Question 4

Dx and FA appearance of red-orange retinal tumor with large caliber tortuous vessels, with associated hard exudates

Answer 4

retinal capillary hemangioblastoma (AD inheritance). rapid AV transit with massive leakage of dye into tumor

Question 5

Diagnosis and genetics of bilateral retinal capillary hemangioblastomas with positive family history?

Answer 5

von Hippel. Considered von Hippel-Lindau if also have cerebellar hemangioblastoma, and vHL patients are at risk for renal cell carcinoma and pheochromocytomas. chromosome 3 is involved in vHL

Question 6

Dx and FA appearance of cluster of grape like vascular lesion with associated white fibrovascular tissue

Answer 6

retinal cavernous hemangioma. very slow filling with fluorescein pooling in the upper part (plasma floats on top of RBCs which sink to bottom)