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 Table of Contents  
LETTER TO THE EDITOR
Year : 2018  |  Volume : 19  |  Issue : 4  |  Page : 272-273

Cavernous hemangioma of the optic disc


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Submission20-May-2018
Date of Acceptance03-Jul-2018
Date of Web Publication20-Dec-2018

Correspondence Address:
Mahmood D Al-Mendalawi
Baghdad Post Office, Postal/zip code 1111, Baghdad, PO Box 55302
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/DJO.DJO_24_18

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How to cite this article:
Al-Mendalawi MD. Cavernous hemangioma of the optic disc. Delta J Ophthalmol 2018;19:272-3

How to cite this URL:
Al-Mendalawi MD. Cavernous hemangioma of the optic disc. Delta J Ophthalmol [serial online] 2018 [cited 2021 Dec 3];19:272-3. Available from: http://www.djo.eg.net/text.asp?2018/19/4/272/248084



Sir,

I read with interest the case report by Aly and Mohamed on the cavernous hemangioma (CH) of the optic disc in an Egyptian patient published in the Delta Journal of Ophthalmology January 2018 issue [1]. The authors nicely described the clinical picture, findings of the fundus and anterior segment slit lamp examination, and the results of various optical imaging studies in the studied patient. I presume that the rare occurrence of CH at an unusual site should alert the authors to take into consideration underlying altered immune status in the studied patient. Among altered immune states, HIV infection is the leading cause. My presumption is based on the following point. It is explicit that individuals infected with HIV are more susceptible to various types of tumors, including vascular tumors compared with immune-competent individuals. The increased susceptibility of HIV-positive individuals to have tumors has been attributed to different factors, including immunosuppression, coinfection with oncogenic viruses and life prolongation secondary to the use of antiretroviral therapy [2]. Among vascular tumors, CH has been reported among HIV-positive patients [3],[4]. To my knowledge, HIV infection is globally a distressing health problem, particularly in developing countries. Although no recent data are yet present on its seroprevalence in Egypt, the available data pointed out that by international standards, HIV/AIDS seroprevalence is low in Egypt (<0.1%) [5]. In spite of Egypt’s conservative culture, high-risk behaviors are more widespread than commonly reported, and the country’s changing socioeconomic context might accentuate the trend of increasing HIV seroprevalence [5]. It has been suggested that constraints, such as Egypt’s cultural norms and laws, the population’s lack of knowledge about HIV/AIDS and the bureaucratic health system might obscure the actual HIV seroprevalence in Egypt [5]. Accordingly, I presume that Aly and Mohamed [1] ought to consider underlying HIV infection in their studied patient. Hence, implementing the diagnostic battery of blood CD4 count and viral overload measurements was envisaged. If that diagnostic battery was done and it disclosed HIV infection, the case in question could be truly considered a novel case report. This is because HIV-associated CH of the optic disc has never been reported in the world literature to date.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. Aly MM, Mohamed IA. Cavernous hemangioma of the optic disc. Delta J Ophthalmol 2018; 19:83–86.
  2. Valencia Ortega ME. Malignancies and infection due to the human immunodeficiency virus. Are these emerging diseases? Rev Clin Esp 2018; 218:149–155.
  3. Moody JA, Litwin MS, Cochran ST, Moe A, Sahmedini D. Renal cavernous hemangioma in a patient with the acquired immunodeficiency syndrome. J Urol 1996; 156:1759–1760.
  4. Akiyama M, Ginsberg HJ, Munoz D. Spinal epidural cavernous hemangioma in an HIV-positive patient. Spine J 2009; 9:e6–e8.
  5. Boutros S, Skordis J. HIV/AIDS surveillance in Egypt: current status and future challenges. East Mediterr Health J 2010; 16:251–258.




Reply: We thank Dr Al-Medalawi for the interest shown in our article [1] and for the comment. Cavernous hemangioma of the retina is a rare benign tumor that is typically an isolated finding but may occur in conjunction with other major abnormalities of the retinal vascular pattern and with intracranial and cutaneous angiomas [2]. The cause of isolated cavernous hemangioma is unknown, but an autosomal dominant disorder has been described [3].



Investigations for immunological disorders including HIV Were performed, and they were negative. So, we think it was just an isolated cavernous hemangioma of the optic disc without any associated disorders of the immune system.



Conflicts of interest

There are no conflicts of interest.

Mona M. Aly1, Ihab A. Mohamed2
1Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt,
2Vitreoretinal Department, Memorial Institute of Ophthalmology, Giza, Egypt

Correspondence to Mona M. Aly, MD, Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Nasr City 11754, Cairo, Egypt. Tel: +20 100 651 4419; fax: +20 222 638 357; e-mail: [email protected]



References

  1. Aly MM, Mohamed IA. Cavernous hemangioma of the optic disc. Delta J Ophthalmol 2018; 19:83-86.
  2. Bruč C, Vance SK, Yannuzzi LA, Freund KB. Cavernous hemangioma associated with retinal macrovessels. Retin Cases Brief Rep 2011; 5(4):323-325.
  3. Verlaan DJ, Davenport WJ, Stefan H, Sure U, Siegel AM, Rouleau GA. Cerebral cavernous malformations: mutations in Krit1. Neurology 2002; 58(6):853-857.











 

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