Retinal hemangioblastoma vascular detail elucidated on swept source optical coherence tomography angiography

PURPOSE: To report the distinct vascular pattern of a treatment-naïve retinal hemangioblastoma imaged on swept source optical coherence tomography angiography (SS-OCTA). OBSERVATIONS: A 33-year-old female with a history of Von Hippel-Lindau disease presented for follow-up of bilateral retinal hemangioblastomas. Ultra-widefield fundus photography of the left eye revealed a small, juxtapapillary lesion. SS-OCTA imaging centered at the lesion identified two distinct vascular foci. Centrally, the lesion was composed of a dense capillary meshwork. Peripherally, a pattern of branching vessels with terminal budding was identified. The patient was diagnosed with a new juxtapapillary retinal hemangioblastoma. CONCLUSIONS AND IMPORTANCE: SS-OCTA can visualize the in-vivo vascular structure of retinal hemangioblastomas. Early lesion identification can help in prompt diagnosis and monitoring. Further investigation is needed to assert if the branching and budding pattern described in this case report is broadly characteristic of this tumor entity.