Case report: Two cases of juxtapapillary retinal capillary hemangioma treated with intraocular cryotherapy

Juxtapapillary retinal capillary hemangioma (JRCH) is a rare vascular tumor arising from or adjacent to the optic disc and may cause visual impairment due to exudation and vitreoretinal interface complications. Its management remains challenging because of the risk of optic nerve damage and the lack of standardized treatment protocols. Cryotherapy is commonly applied transsclerally for peripheral retinal capillary hemangioma (RCH) but has been rarely used for JRCH. Reports of intraocular cryotherapy are even more limited.

We report two pediatric cases of isolated JRCH with an endophytic growth pattern. The first case involved a 6-year-old girl presenting with JRCH complicated by exudative retinal detachment. She showed a limited response to repeated laser photocoagulation and intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, and underwent pars plana vitrectomy (PPV) to relieve vitreoretinal traction. However, peripapillary vascular dilation and exudation persisted. She subsequently underwent intraocular cryotherapy, resulting in tumor regression and reduced exudation, with stable disease maintained during follow-up. The second case involved a 10-year-old girl presenting with JRCH complicated by macular edema and significant vitreoretinal traction. She underwent PPV, epiretinal membrane peeling, and intraocular cryotherapy. The tumor demonstrated a similarly favorable response to intraocular cryotherapy.

Anatomical stabilization was observed during the available follow-up period after treatment including intraocular cryotherapy. These cases provide preliminary clinical experience with intraocular cryotherapy for the management of complex JRCH. Further studies are needed to evaluate its safety, efficacy, and long-term outcomes.