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Show Poster 29 Long Term Follow-Up Of Two Cases Of Optic Nerve Head Angioma; A Photo Essay. Su Ann Lim1, Nicola Gan1, Rajesh Rajagopalan1 1 Tan Tock Seng Hospital, Singapore, Singapore Introduction: Optic nerve head angiomas (ONHA) are uncommon, as such there is little regarding the natural history and management of these lesions. This poster aims to share our follow-up of two patients (11 and 8 years) with these rare tumors. Description of Case(s): Case 1: Thirty-six-year-old female with Von Hippel Lindau Syndrome (VHLS) presented to us in 2014 with an incidental finding of a left optic nerve head (ONH) lesion. She had photographic documentation of the lesion since 2008. Visual acuity remained 6/6 till April 2019 when it dropped to 6/24, despite macular edema documented by ocular coherence tomography since 2012. Her acuity decreased as she developed a full thickness macular hole. She underwent trans pars plana vitrectomy with membrane peel in May 2019. Post operatively her vision improved to 6/15 with anatomic closure of the macular hole, albeit with persistent macular edema. Case 2: Seventy-eight-year-old female with diabetes, hypertension, ischemic heart disease and renal failure (on dialysis) was on follow-up for normal tension glaucoma and diabetic retinopathy. A drance hemorrhage was noted on her right ONH in 2012, this however increased in size and fluorescein angiography in 2014 was consistent with ONHA. She had no evidence of VHLS. Vision was 6/9 in 2013 due to epiretinal membrane from vitreomacular traction, slow deterioration to 6/15 in 2015 and presently 6/30 is secondary to macular edema. She had small amounts of vitreous hemorrhage in 2015 as again in 2019. She was offered photodynamic therapy but declined due to her myriad of other medical problems. Conclusions, including unique features of the case(s): Although ONHA are benign tumors, they result in slow deterioration of vision due to edema of the surrounding retina or vitreous hemorrhage. There is presently no good treatment for this condition. References: None. Keywords: Tumors, Neuro-ophth & systemic disease (eg. MS, MG, thyroid), Vascular disorders, Optic neuropathy Financial Disclosures: The authors had no disclosures. Grant Support: None. Contact Information: su_ann_lim@ttsh.com.sg 86 | North American Neuro-Ophthalmology Society |
