Normalization of Congenital Venous Stasis Retinopathy Following Sclerotherapy of a Macrocystic Lymphatic Malformation

Ophthalmic Plast Reconstr Surg. 2018 Jan/Feb;34(1):e19-e21. doi: 10.1097/IOP.0000000000000975.

Abstract

The authors describe, for the first time to their knowledge, a case of a congenital macrocystic lymphatic malformation of the orbit with associated venous stasis retinopathy that acutely normalized after drainage and sclerotherapy of the lesion. Prenatal ultrasound revealed prominence of the left orbital soft tissue, and at birth, the patient was noted to have unilateral proptosis, tortuous retinal vessels, and intraretinal hemorrhages in all 4 quadrants in the left eye. MRI demonstrated a primarily intraconal, multiloculated, T2-hyperintense mass consistent with a lymphatic malformation. Ultrasound-guided cyst aspiration and sclerotherapy was performed, with subsequent improvement of the proptosis and resolution of the vessel tortuosity and intraretinal hemorrhages. Although venous stasis retinopathy is usually related to central retinal vein occlusion or carotid artery occlusive disease, any entity that increases orbital venous resistance can generate retinal venous dilation and intraretinal hemorrhages, including an orbital lymphatic malformation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dexamethasone / administration & dosage
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Humans
  • Infant, Newborn
  • Injections, Intravenous
  • Lymphatic Abnormalities / diagnosis
  • Lymphatic Abnormalities / drug therapy*
  • Lymphatic Abnormalities / surgery
  • Magnetic Resonance Imaging
  • Orbital Diseases / congenital
  • Orbital Diseases / drug therapy*
  • Orbital Diseases / surgery
  • Paracentesis / methods
  • Recovery of Function*
  • Regional Blood Flow / physiology
  • Retinal Diseases / chemically induced*
  • Retinal Diseases / diagnosis
  • Retinal Diseases / drug therapy
  • Retinal Vein / physiopathology*
  • Sclerosing Solutions / adverse effects*
  • Sclerotherapy / adverse effects*
  • Surgery, Computer-Assisted / methods

Substances

  • Glucocorticoids
  • Sclerosing Solutions
  • Dexamethasone