|Year : 2021 | Volume
| Issue : 4 | Page : 848-849
Field emission scanning electron microscopy study of orbital venous malformation
Dipankar Das1, Kasturi Bhattacharjee2, Surjendu Maity3, Saurabh Deshmukh4, Riddhi Raichura4, Mohit Garg4, Apurba Deka5
1 Department of Uvea, Ocular Pathology and Neuro-ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
2 Department of Oculoplasty, Cataract and Refractive Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
3 Centre for Nanotechnology and Department of Chemical Engineering, Indian Institute of Technology, Guwahati, Assam, India
4 Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
5 Department of Ocular Pathology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
|Date of Submission||16-Apr-2021|
|Date of Acceptance||13-Jun-2021|
|Date of Web Publication||09-Oct-2021|
Dr. Dipankar Das
Senior Consultant and HOD: Uveitis-Ocular Pathology Services, Department of Ocular Pathology, Uveitis and Neuro-Ophthalmology, Sri Sankaradeva Nethralaya, 96 Basistha Road, Beltola, Guwahati - 781 028, Assam
Source of Support: None, Conflict of Interest: None
Keywords: Malformation, orbitotomy, proptosis, venous
|How to cite this article:|
Das D, Bhattacharjee K, Maity S, Deshmukh S, Raichura R, Garg M, Deka A. Field emission scanning electron microscopy study of orbital venous malformation. Indian J Ophthalmol Case Rep 2021;1:848-9
|How to cite this URL:|
Das D, Bhattacharjee K, Maity S, Deshmukh S, Raichura R, Garg M, Deka A. Field emission scanning electron microscopy study of orbital venous malformation. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Oct 28];1:848-9. Available from: https://www.ijoreports.in/text.asp?2021/1/4/848/327711
Venous malformations (VMs) can present in eye and adnexa.,,,, Very recently, these anomalies have been classified based on a number of criteria.,,,,
A 40-year-old Indian male presented with proptosis in the left eye (OS). It was gradual progressive in nature. There was no orbital or ocular pain. There was no complaint of diplopia or diminution of vision. On physical examination, there was no local heat, tenderness, or thrill felt on palpation over the proptosed area. Fundus examination was within normal limits. Magnetic resonance imaging in sagittal scan of the brain and orbit showed a well-defined, lobulated, moderately heterogeneous contrast-enhanced lesion with intraconal portion of the left orbit having adjoining mass effect, which was suggestive of benign intraconal VMs [Figure 1]. Blood investigations were normal. Left-sided lateral orbitotomy was carried out under general anesthesia with proper consent. The specimen measured 24.3 × 20.1 × 18.6 mm and was bluish-black in color [Figure 2]a. The cut section of the lesion showed large blood filled cavities [Figure 2]b. Microscopic appearance of the lesion showed capsule with numerous engorged blood vessels lined by endothelial cells with intervening fibrous septas [Figure 3]a. A portion of the lesion was subjected to field emission electron microscopy (FESEM) study which showed characteristic endothelial cells studded over the wall of the blood vessels [Figure 3]b.
|Figure 1: Magnetic resonance imaging (MRI) of the brain and orbit in sagittal view in T1-weighted image showing a well-defined, lobulated, moderately heterogeneous contrast-enhanced lesion with numerous thin hypointense incomplete septae in intraconal portion of the left orbit having adjoining mass effect suggestive of benign intraconal VMs|
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|Figure 2: (a) Gross photograph of the bluish black colored specimen measuring 24.3 × 20.1 × 18.6 mm. Surface vascularity were noted over the capsule. (b) Cut section of the lesion showed large blood filled spaces. They were enhanced grossly by putting a drop of 95% alcohol over the raw area.|
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|Figure 3: (a) Microscopic appearance of the lesion with numerous engorged blood vessels lined by endothelial cells and intervening fibrous septas (H and E, ×40). (b) Field emission electron microscopy picture of characteristic endothelial cells studded over the wall of the blood vessels (×8000).|
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| Discussion|| |
VMs are composed of abnormal collection of veins that have variable luminal wall thickness, size, and can be superficial or deep.,,,, VMs were previously called as cavernous hemangiomas.,, These are classified under slow flow lesion category by International Society for the Study of Vascular Anomalies. These anomalies are common in the orbit and seen in the third to sixth decade of life.,, By FESEM observations, we could see that endothelial cells were normally spaced without any irregularity and sprouting. Tumor endothelial cells did not show great variations unlike the observations made by author (s) in 2016 by compound microscopy study.
This case is first of its kind in the literature to document the FESEM features of orbital VM.
The authors would like to thank:
- Prof. Panna Deka, MD;
- Prof. Dipankar Bandyopadhyay, PhD, Centre for Nanotechnology and Department of Chemical Engineering, Indian Institute of Technology Guwahati, Assam, India; and
- Sri Kanchi Sankara Health and Educational Foundation, Guwahati, India
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has/have given his consent for his images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]