PMC7132355_01
(a) Facial appearance of the patient at presentation. (b) Color fundus photograph of the right eye shows prominent optic disc edema and subtle macular compression. (c) Orbital T1-weighted axial magnetic resonance imaging shows an intraconal tumor isointense to the extraocular muscles producing compression of the globe and indenting the optic nerve.
CRIOPM2020-5354609.001.jpg
PMC7132355_01_CRIOPM2020-5354609.001.jpg
fig1
There was 7 mm proptosis on the right side (Figure 1(a)). Choroidal folds were not present (Figure 1(b)). The mass was isointense with respect to the extraocular muscles on T1-weighted images, hyperintense on T2-weighted images, and demonstrated contrast enhancement (Figure 1(c)).
(a) Swept-source optical coherence tomography through the fovea reveals a smooth contoured elevation of the posterior pole without any distortion of retinal structures, giving a dome-shaped maculopathy-like appearance. (b-e) Swept-source optical coherence tomography angiography images of superficial retinal plexus (b), deep retinal plexus (c), outer retina (d), and choriocapillaris (e) show normal retinal and choroidal vasculature patterns.
CRIOPM2020-5354609.002.jpg
PMC7132355_01_CRIOPM2020-5354609.002.jpg
fig2
Triton plus, Topcon, Tokyo, Japan) operating at a speed of 100.000 A-scans/second revealed a smooth contoured elevation of the posterior pole without any distortion of retinal structures, an appearance closely simulating DSM (Figures 2(a)). There was no retinal traction or choroidal folds. Swept-source optical coherence tomography angiography (SS-OCTA) revealed normal vascularisation in superficial and deep retinal plexi, outer retina, and choriocapillaris (Figure 2(b)-2(e)).
(a) Gross appearance of the excised orbital tumor showing the reddish well-circumscribed mass. (b) Histopathological examination reveals enlarged vascular channels with thick walls, the lumens of which were filled with erythrocytes, consistent with orbital cavernous hemangioma (H.E.x20). (c) Higher magnification view of vascular structures lined by endothelium and filled with erythrocytes (H.E.x100).
CRIOPM2020-5354609.003.jpg
PMC7132355_01_CRIOPM2020-5354609.003.jpg
fig3
The base diameters of the excised reddish, smooth edged, capsulated mass measured approximately 2.5 x 1.5 cm (Figure 3(a)). The histopathological diagnosis was rendered as orbital cavernous hemangioma (Figures 3(b) and 3(c)).
(a) Clinical appearance of the patient one month after orbitotomy showing that the right inferotemporal orbitotomy skin incision has nicely healed. (b) Fundus photograph shows significant resolution of optic disc edema and no macular compression. (c) Swept-source optical coherence tomography shows complete resolution of dome-shaped maculopathy-like appearance.
CRIOPM2020-5354609.004.jpg
PMC7132355_01_CRIOPM2020-5354609.004.jpg
fig4
Ophthalmological examination 1 month after the surgery showed that the right orbitotomy skin incision had nicely healed (Figure 4(a)). Visual acuity improved to 20/20, and optic disc edema resolved significantly in the right eye (Figure 4(b)). SS-OCT showed complete resolution of the DSM-like appearance at the posterior pole (Figure 4(c)).