Cavernous Hemangioma

A cavernous hemangioma of the retina is a rare vascular tumor composed of clumps of dark intraretinal aneurysms that demonstrate a characteristic “cluster of grapes” appearance. The retinal cavernous hemangiomas are composed of clusters of saccular aneurysms filled with clotted blood.

The appearance can be confused with retinal telangiectasis, Coats disease, or Leber’s miliary aneurysms. The cavernous hemangioma is a sensible tumor projecting from and partly isolated from the blood vessels. Growth of a retinal cavernous hemangioma is exceedingly rare. It can occur on the optic nerve head as well.

These tumors rarely increase in size or cause lipid exudation or severe vitreous hemorrhage, so do not generally need to be treated. Photocoagulation or cryotherapy or vitrectomy have been advocated if vitreous hemorrhage or exudation occurs.

Although the pattern of inheritance has not been clearly established, pedigrees such as those reported by Goldberg and Pancurak suggest autosomal dominance with incomplete penetrance or variable expression.

Angiomas of the central nervous system and cutaneous lesions have been reported with this tumor. CT scan and MRI is indicated in patients and family members of patients because of the possibility of intracranial hemorrhage.