Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain

Importance Congenital retinal macrovessel (CRM) is a rarely reported venous malformation of the retina that is associated with venous anomalies of the brain. Objective To study the multimodal imaging findings of a series of eyes with congenital retinal macrovessel and describe the systemic associati...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Pichi, Francesco (author)
مؤلفون آخرون: Freund, Bailey (author), Ciardella, Antonio (author), Moara, Mariachiara (author), Abboud, Emad B. (author), Ghazi, Nicola (author)
التنسيق: article
منشور في: 2018
الوصول للمادة أونلاين:http://hdl.handle.net/10725/10866
https://doi.org/10.1001/jamaophthalmol.2018.0150
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2673570
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author Pichi, Francesco
author2 Freund, Bailey
Ciardella, Antonio
Moara, Mariachiara
Abboud, Emad B.
Ghazi, Nicola
author2_role author
author
author
author
author
author_facet Pichi, Francesco
Freund, Bailey
Ciardella, Antonio
Moara, Mariachiara
Abboud, Emad B.
Ghazi, Nicola
author_role author
dc.creator.none.fl_str_mv Pichi, Francesco
Freund, Bailey
Ciardella, Antonio
Ciardella, Antonio
Moara, Mariachiara
Abboud, Emad B.
Ghazi, Nicola
dc.date.none.fl_str_mv 2018
2019-06-19T10:03:14Z
2019-06-19T10:03:14Z
2019-06-19
dc.identifier.none.fl_str_mv 2168-6173
http://hdl.handle.net/10725/10866
https://doi.org/10.1001/jamaophthalmol.2018.0150
Pichi, F., Freund, K. B., Ciardella, A., Morara, M., Abboud, E. B., Ghazi, N., ... & Arevalo, J. F. (2018). Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain. JAMA ophthalmology, 136(4), 372-379.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2673570
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv JAMA Ophtalmology
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description Importance Congenital retinal macrovessel (CRM) is a rarely reported venous malformation of the retina that is associated with venous anomalies of the brain. Objective To study the multimodal imaging findings of a series of eyes with congenital retinal macrovessel and describe the systemic associations. Design, Setting, and Participants In this cross-sectional multicenter study, medical records were retrospectively reviewed from 7 different retina clinics worldwide over a 10-year period (2007-2017). Patients with CRM, defined as an abnormal, large, macular vessel with a vascular distribution above and below the horizontal raphe, were identified. Data were analyzed from December 2016 to August 2017. Main Outcomes and Measures Clinical information and multimodal retinal imaging findings were collected and studied. Pertinent systemic information, including brain magnetic resonance imaging findings, was also noted if available. Results Of the 49 included patients, 32 (65%) were female, and the mean (SD) age at onset was 44.0 (20.9) years. A total of 49 eyes from 49 patients were studied. Macrovessel was unilateral in all patients. Color fundus photography illustrated a large aberrant dilated and tortuous retinal vein in all patients. Early-phase frames of fluorescein angiography further confirmed the venous nature of the macrovessel in 40 of 40 eyes. Optical coherence tomography angiography, available in 17 eyes (35%), displayed microvascular capillary abnormalities around the CRM, which were more evident in the deep capillary plexus. Of the 49 patients with CRM, 39 (80%) did not illustrate any evidence of ophthalmic complications. Ten patients (20%) presented with retinal complications, typically an incidental association with CRM. Twelve patients (24%) were noted to have venous malformations of the brain with associated magnetic resonance imaging. Of these, location of the venous anomaly in the brain was ipsilateral to the CRM in 10 patients (83%) and contralateral in 2 patients (17%), mainly located in the frontal lobe in 9 patients (75%). Conclusions and Relevance Our study has identified an association between macrovessels in the retina and venous anomalies of the brain (24% compared with 0.2% to 6.0% in the normal population). Thus, we recommend new guidelines for the systemic workup of patients with CRM to include brain magnetic resonance imaging with contrast. These lesions may be more accurately referred to as retinal venous malformations, which may raise awareness regarding potential cerebral associations.
eu_rights_str_mv openAccess
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Pichi, F., Freund, K. B., Ciardella, A., Morara, M., Abboud, E. B., Ghazi, N., ... & Arevalo, J. F. (2018). Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain. JAMA ophthalmology, 136(4), 372-379.
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spelling Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brainPichi, FrancescoFreund, BaileyCiardella, AntonioCiardella, AntonioMoara, MariachiaraAbboud, Emad B.Ghazi, NicolaImportance Congenital retinal macrovessel (CRM) is a rarely reported venous malformation of the retina that is associated with venous anomalies of the brain. Objective To study the multimodal imaging findings of a series of eyes with congenital retinal macrovessel and describe the systemic associations. Design, Setting, and Participants In this cross-sectional multicenter study, medical records were retrospectively reviewed from 7 different retina clinics worldwide over a 10-year period (2007-2017). Patients with CRM, defined as an abnormal, large, macular vessel with a vascular distribution above and below the horizontal raphe, were identified. Data were analyzed from December 2016 to August 2017. Main Outcomes and Measures Clinical information and multimodal retinal imaging findings were collected and studied. Pertinent systemic information, including brain magnetic resonance imaging findings, was also noted if available. Results Of the 49 included patients, 32 (65%) were female, and the mean (SD) age at onset was 44.0 (20.9) years. A total of 49 eyes from 49 patients were studied. Macrovessel was unilateral in all patients. Color fundus photography illustrated a large aberrant dilated and tortuous retinal vein in all patients. Early-phase frames of fluorescein angiography further confirmed the venous nature of the macrovessel in 40 of 40 eyes. Optical coherence tomography angiography, available in 17 eyes (35%), displayed microvascular capillary abnormalities around the CRM, which were more evident in the deep capillary plexus. Of the 49 patients with CRM, 39 (80%) did not illustrate any evidence of ophthalmic complications. Ten patients (20%) presented with retinal complications, typically an incidental association with CRM. Twelve patients (24%) were noted to have venous malformations of the brain with associated magnetic resonance imaging. Of these, location of the venous anomaly in the brain was ipsilateral to the CRM in 10 patients (83%) and contralateral in 2 patients (17%), mainly located in the frontal lobe in 9 patients (75%). Conclusions and Relevance Our study has identified an association between macrovessels in the retina and venous anomalies of the brain (24% compared with 0.2% to 6.0% in the normal population). Thus, we recommend new guidelines for the systemic workup of patients with CRM to include brain magnetic resonance imaging with contrast. These lesions may be more accurately referred to as retinal venous malformations, which may raise awareness regarding potential cerebral associations.PublishedN/A2019-06-19T10:03:14Z2019-06-19T10:03:14Z20182019-06-19Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2168-6173http://hdl.handle.net/10725/10866https://doi.org/10.1001/jamaophthalmol.2018.0150Pichi, F., Freund, K. B., Ciardella, A., Morara, M., Abboud, E. B., Ghazi, N., ... & Arevalo, J. F. (2018). Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain. JAMA ophthalmology, 136(4), 372-379.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttps://jamanetwork.com/journals/jamaophthalmology/article-abstract/2673570enJAMA Ophtalmologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/108662021-03-19T10:45:17Z
spellingShingle Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain
Pichi, Francesco
status_str publishedVersion
title Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain
title_full Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain
title_fullStr Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain
title_full_unstemmed Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain
title_short Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain
title_sort Congenital retinal macrovessel and the association of retinal venous malformations with venous malformations of the brain
url http://hdl.handle.net/10725/10866
https://doi.org/10.1001/jamaophthalmol.2018.0150
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2673570