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Therapeutic options for capillary papillary hemangiomas
J Garcia-Arumí1, L H Sararols, L Cavero
1Hospital Vall d'Hebrón, Universidad Autónoma de Barcelona, Spain.
Purpose:
To describe the results and therapeutic complications of treatment of papillary capillary hemangiomas over the last 13 years.
Design:
Retrospective, noncomparative, interventional case series.
Participants:
Five cases of unilateral capillary papillary hemangiomas were reviewed. Three patients had von Hippel-Lindau disease, and two had no associated familial or systemic disease.
Methods:
Two patients were treated with argon green laser, one patient received argon green and diode photocoagulation, and two patients underwent argon green photocoagulation and diode transpupillary thermotherapy (TTT); two eyes also underwent vitreoretinal surgery. Follow-up ranged from 1 to 13 years.
Main Outcome Measures:
The presence of exudative retinal detachment associated with the activity of the hemangioma and the visual acuity were the two main parameters.
Results:
Prompt argon green laser treatment was the most effective therapy; -II was ineffective. Vitreoretinal surgery, transscleral drainage, and argon endolaser photocoagulation in one case resolved bullous retinal detachment secondary to tumor exudation. Pretreatment visual acuity (VA) levels ranged from 20/25 to counting fingers; posttreatment VA levels ranged from 20/25 to light perception.
Conclusions:
If left untreated, papillary hemangiomas may evolve to exudative retinal detachment and marked VA decreases. Although we have not established an ideal therapy, we recommend appropriate treatment on diagnosis. Close follow-up and multiple treatments with argon laser are likely the best therapeutic course.