OSLI Retina

June 2020

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June 2020 · Vol. 51, No. 6 365 ■ I M A G E S I N O P H T H A L M O L O G Y ■ Retinal Artery Macroaneurysm Associated With Retinal Hemangioblastoma Nora C. Elson, MS; Ferdinand Rodriguez, MD; Maura Di Nicola, MD; Basil K. Williams Jr., MD A 34-year-old Caucasian woman with a past medical history of hypertension presented with acute floaters in the right eye (OD) for 1 week. Best-corrected visual acu- ity (VA) was 20/20 in both eyes. Fundus examination OD (Figure 1) revealed a retinal hemangioblastoma (RH) in the temporal midperiphery with a prominent feeding artery and draining vein. A retinal arterial microaneurysm (RAM) was noted with- in the feeding artery, and subretinal hemorrhage with a cuff of fluid was present. Fundus autofluorescence (Figure 2) showed hypoautofluorescence in the area of the RH, RAM, and subretinal hemorrhage. A hyperauto- fluorescent ring surrounding the hemorrhage suggested shallow subretinal fluid. Early phase fluorescein angi- ography (Figure 3) demonstrated appropriate arterial and venous filling and hyperfluorescence of the RH. Figure 1. Ultra-widefield fundus photograph of the right eye reveal- ing a midperipheral retinal hemangioblastoma with a prominent feeding artery and draining vein. A retinal arterial microaneurysm arises from the feeding artery, producing subretinal hemorrhage with a surrounding cuff of subretinal fluid, and a small amount of intraretinal and vitreous hemorrhage along the inferior arcade. Figure 2. Fundus autofluorescence demonstrates hypoautofluo- rescence corresponding to the retinal hemangioblastoma, retinal arterial microaneurysm, and intraretinal and subretinal hemor- rhage with a ring of hyperautofluorescence around hemorrhage, suggestive of subretinal fluid. From Cincinnati Eye Institute, Cincinnati, Ohio (NCE, FR, BKW); and Ocular Oncology Service, Department of Ophthalmology, University of Cincinnati Col- lege of Medicine, Cincinnati, Ohio (NCE, MDN, BKW). Originally submitted February 19, 2020. Revision received March 17, 2020. Accepted for publication March 30, 2020. The authors report no relevant financial disclosures. Address correspondence to Basil K. Williams Jr., MD, Ocular Oncology Service, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Suite 5414, Cincinnati, OH 45267; email: basilkwilliams@gmail.com. doi: 10.3928/23258160-20200603-07

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