Suprachoroidal hemorrhage due to Valsalva maneuver, importance of enhanced depth imaging optical coherence tomography in differential diagnosis.

We describe a case report of a spontaneous suprachoroidal hemorrhage, in which the enhanced depth imaging optical coherence tomography (OCT-EDI) is extremely useful in establish the differential diagnosis with a choroidal tumor. A 70 year-old woman was referred with a central scotoma after a Valsalva maneuver. In the posterior pole we observed a grey bilobed subretinal mass with the appearance of a choroidal tumor. OCT-EDI revealed an optically dark region with a scalloped anterior tumor contour and subretinal fluid, the choroicapillaris appeared to be intact and displaced anteriorly. The diagnosis was a suprachoroidal hemorrhage and it resolved in 12 weeks. Spontaneous suprachoroidal hemorrhage is a rare condition and it can resemble choroidal tumor. OCT-EDI is a very valuable tool in the differentiation of hemorrhage from tumors.

Hemorragia supracoroidea secundaria a maniobra de Valsalva, importancia de la tomografía de coherencia óptica de profundidad mejorada en el diagnóstico diferencial / Suprachoroidal hemorrhage due to Valsalva maneuver, importance of enhanced depth imaging optical coherence tomography in differential diagnosis

Presentamos el caso clínico de una hemorragia supracoroidea espontánea, en el que la tomografía de coherencia óptica de profundidad mejorada (OCT-EDI) resulta de gran utilidad para el diagnóstico diferencial con un tumor coroideo. Una mujer de 70 años con hipertensión arterial, acude por escotoma central tras maniobra de Valsalva. En el fondo de ojo observamos una masa bilobulada central, subretiniana y grisácea, que plantea diagnóstico diferencial con un tumor coroideo. En la OCT-EDI se observa una masa coroidea con superficie de tipo festoneado y líquido subretiniano, el tejido coriocapilar se encuentra desplazado anteriormente con apariencia normal. Diagnosticamos una hemorragia supracoroidea, que se resuelve espontáneamente en 12 semanas. La hemorragia supracoroidea espontánea es muy poco frecuente y presenta una imagen que puede ser confundida con un tumor coroideo, la OCT-EDI es la prueba de imagen más útil para el diagnóstico diferencial (AU)

We describe a case report of a spontaneous suprachoroidal hemorrhage, in which the enhanced depth imaging optical coherence tomography (OCT-EDI) is extremely useful in establish the differential diagnosis with a choroidal tumor. A 70 year-old woman was referred with a central scotoma after a Valsalva maneuver. In the posterior pole we observed a grey bilobed subretinal mass with the appearance of a choroidal tumor. OCT-EDI revealed an optically dark region with a scalloped anterior tumor contour and subretinal fluid, the choroicapillaris appeared to be intact and displaced anteriorly. The diagnosis was a suprachoroidal hemorrhage and it resolved in 12 weeks. Spontaneous suprachoroidal hemorrhage is a rare condition and it can resemble choroidal tumor. OCT-EDI is a very valuable tool in the differentiation of hemorrhage from tumors (AU)

Hemorragia vítrea una rara manifestación del hamartoma astrocítico retiniano: a propósito de un caso pediátrico / Vitreous haemorrhage a rare manifestation of retinal astrocytic hamartoma: a paediatric case report

Introducción: El hamartoma astrocítico retiniano es un tumor benigno generalmente asintomático, asociado o no al complejo de esclerosis tuberosa. La hemorragia vítrea es una rara presentación. Caso clínico: Paciente de 12 años acude por visión de "una mancha negra" en el hemicampo temporal superior del ojo derecho. Refiere un episodio similar hace 2 años. En lámpara de hendidura el polo anterior es normal. En la funduscopia se evidencia una masa de aspecto translúcido blanco-amarillenta peripapilar y hemorragia vítrea peripapilar. Las características de la autofluorescencia, angiografía fluoresceínica y la tomografía de coherencia óptica son compatibles con un hamartoma astrocítico retiniano. Los estudios complementarios (serología y radiografías) y examen clínico completo descartan afectación sistémica asociada. Se procedió a un seguimiento estrecho del paciente hasta reabsorción de la hemorragía vítrea. Conclusión: La hemorragia vítrea es una rara complicación de hamartoma astrocítico retiniano y dificulta la exploración fundoscópica. Debería descartarse afectación sistémica

Introduction: Retinal astrocytic hamartoma is generally an asymptomatic benign tumour that may or may not be associated with the tuberous sclerosis complex. Haemorrhage is a rare presentation. Case report: The case concerns a 12-year-old patient with "a black spot" vision in the upper temporal hemifield of the right eye, who referred a similar episode 2 years ago. The anterior pole was normal in the slit lamp. A mass of translucent white-yellow peri-papillary appearance and vitreous peri-papillary haemorrhage was observed in funduscopy. The autofluorescence, fluorescence angiography, and optical coherence tomography characteristics were all compatible with retinal astrocytic hamartoma. Complementary studies (serology and X-rays) and the complete clinical examination rule out associated systemic involvement. The patient was followed-up closely until the vitreous haemorrhage was reabsorbed. Conclusion: Vitreous haemorrhage is a rare complication of Retinal astrocytic hamartoma and funduscopic exploration is difficult. Systemic involvement should be ruled out

Vitreous haemorrhage a rare manifestation of retinal astrocytic hamartoma: a paediatric case report. / Hemorragia vítrea una rara manifestación del hamartoma astrocítico retiniano: a propósito de un caso pediátrico.

INTRODUCTION: Retinal astrocytic hamartoma is generally an asymptomatic benign tumour that may or may not be associated with the tuberous sclerosis complex. Haemorrhage is a rare presentation. CASE REPORT: The case concerns a 12-year-old patient with "a black spot" vision in the upper temporal hemifield of the right eye, who referred a similar episode 2 years ago. The anterior pole was normal in the slit lamp. A mass of translucent white-yellow peri-papillary appearance and vitreous peri-papillary haemorrhage was observed in funduscopy. The autofluorescence, fluorescence angiography, and optical coherence tomography characteristics were all compatible with retinal astrocytic hamartoma. Complementary studies (serology and X-rays) and the complete clinical examination rule out associated systemic involvement. The patient was followed-up closely until the vitreous haemorrhage was reabsorbed. CONCLUSION: Vitreous haemorrhage is a rare complication of Retinal astrocytic hamartoma and funduscopic exploration is difficult. Systemic involvement should be ruled out.

Neurorretinopatía macular aguda: a propósito de un caso / Acute macular neuroretinopathy: a case report

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Maculopatía en torpedo con desprendimiento seroso del epitelio pigmentario de la retina / Torpedo maculopathy with serous detachment of retinal pigment epithelium

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Antonio Vena fue el primero / Antonio Vena was the first

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El signo de Antonio Vena / Antonio Vena's sign

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Clasificación clínica y opciones de tratamiento médico en el glaucoma en la infancia / Clinical classification and medical treatment options in childhood glaucoma

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