Evaluation of lymphatic vessel dilatations by anterior segment swept-source optical coherence tomography: case report

Eva Volek,Miklos Schneider,Zoltan Zsolt Nagy,Jeannette Toth

doi:10.1186/s12886-017-0588-y

Eva Volek, Miklos Schneider + Show 2 more

Open Access

https://doi.org/10.1186/s12886-017-0588-y

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Journal: BMC ophthalmology	Publication Date: Oct 23, 2017
Citations: 8	License type: open-access

Affiliation: Semmelweis University

Abstract

BackgroundConjunctival lymphangiectasia is a rare condition presumably caused by the obstruction of lymphatic channels or by an abnormal connection between conjunctival lymphatic and blood vessels. Diagnosis is based on clinical appearance and histology. We report a case of conjunctival lymphangiectasia in which anterior segment optical coherence tomography (OCT) was used to assist the diagnosis and the planning of the biopsy location.Case presentationA 31-year-old woman was referred with repeated episodes of conjunctival “hemorrhages” and chemosis with extended recovery periods over the last months. Other symptoms were dryness, redness, burning sensation and itching. Photo documentation, anterior segment OCT, ultrasound, computer tomography (CT) and magnetic resonance imaging (MRI) of the brain were performed. MRI revealed dilated atypical Virchow-Robin space (VRS). Conjunctival biopsy was taken and the location of the biopsy was selected based on OCT findings.Based on the clinical appearance we suspected the case to be conjunctival lymphangiectasia or lymphangioma. Histology and immunhistochemistry confirmed the diagnosis of conjunctival lymphangiectasia.ConclusionsAnterior segment OCT is a non-invasive tool, useful in the evaluation of conjunctival lesions and planning surgery.

Highlights

Conjunctival lymphangiectasia is a rare condition presumably caused by the obstruction of lymphatic channels or by an abnormal connection between conjunctival lymphatic and blood vessels
Conjunctival lymphatic vessel dilatation known as conjunctival lymphangiectasia is a rare condition which is presumably caused by the obstruction of lymphatic channels or by the abnormal connection between conjunctival lymphatic and blood vessels [1,2,3]
It exists in two different forms: (1) as a diffuse enlargement of lymphatic vessels with the clinical appearance of chemosis, and (2) as focally dilated lymphatics that manifests as series of cysts (“string of pearls”) or sausage-shaped clear-walled channels

Summary

Introduction

Conjunctival lymphangiectasia is a rare condition presumably caused by the obstruction of lymphatic channels or by an abnormal connection between conjunctival lymphatic and blood vessels. Conclusions: Anterior segment OCT is a non-invasive tool, useful in the evaluation of conjunctival lesions and planning surgery. She was followed over the last 15 years by another department because of dilatation of conjunctival blood vessels in the right eye. Slit lamp biomicroscopy revealed diffuse chemosis, dilated, tortuous blood-filled conjunctival vessels, affecting the temporal, nasal and inferior quadrant of the right eye (Fig. 1.).

Results

Conclusion