J Korean Ophthalmol Soc.  2020 Mar;61(3):298-302. 10.3341/jkos.2020.61.3.298.

360° Circumferential Hemorrhagic Lymphangiectasia of the Conjunctivae

Affiliations
  • 1St. Mary Eye Center, Chungju, Korea.
  • 2Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea. cmj@gilhospital.com

Abstract

PURPOSE
We report a case of hemorrhagic lymphangiectasia of the conjunctiva with a 360° connected circumference, which recovered spontaneously.
CASE SUMMARY
A 44-year-old female patient presented with congestion of the right eye 1 day prior to her visit. There was no history of any systemic disease or trauma, but she had experienced relapses of the same episode three times before the visit. There were no accompanying symptoms such as decreased vision or pain. Blood analysis, orbital computed tomography, and angiographic findings showed no remarkable finding. Slit lamp examination showed circumferential lymphatic dilatation extending 360° under the conjunctiva of the eye at a distance of about 6 mm behind the limbus of the right eye, which was accompanied by intralymphatic bleeding. Irregular local lymphatic dilatations were observed on the bulbar conjunctiva at 4 and 8 o'clock of the left eye. The bleeding spontaneously resolved in about 2 weeks, but the translucent enlarged lymphatic vessels were still observed on slit lamp examination and anterior segment optical coherence tomography.
CONCLUSIONS
This is the first reported case of hemorrhagic lymphangiectasia involving 360° of the bulbar conjunctiva in Republic of Korea.

Keyword

Conjunctivae; Hemorrhagic lymphangiectasia; Lymphangiectasia haemorrhagica conjunctivae

MeSH Terms

Adult
Conjunctiva*
Dilatation
Estrogens, Conjugated (USP)
Female
Hemorrhage
Humans
Lymphatic Vessels
Orbit
Recurrence
Republic of Korea
Slit Lamp
Tomography, Optical Coherence
Estrogens, Conjugated (USP)

Figure

  • Figure 1. Anterior segment photography (at first visit). Slit lamp microscopy of right eye reveals a circumferential (360°) engorgement of the bulbar conjunctival lymphatic vessels filled with blood. (A) Inferotemporal, (B) inferonasal, (C) temporal, (D) nasal.

  • Figure 2. Anterior segment photography (2 weeks after first visit). There are varicose tortuous and transparent lymphatic vessels at the site of previously blood-filled vessels. (A) Superotemporal, (B) superonasal, (C) inferotemporal, (D) inferonasal.

  • Figure 3. Anterior segment optical coherence tomography. The enlarged lymphatic vessels are shown. (A) Right eye, (B) left eye.


Reference

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