A Case Report of Primary Vitrectomy in Multiple Bilateral Retinal Capillary Hemangiomas Accompanying Epiretinal Membrane

Abstract

Purpose:To report the clinical result of pars plana vitrectomy (PPV) as the primary treatment in a patient with multiple bilateral retinal capillary hemangiomas (RCH) accompanying epiretinal membrane (ERM). Case summary: A 17-year-old female patient visited our clinic for decreased bilateral vision 4 days in duration. At the first visit, the vision in her right eye was 20/25 and, 20/100 in her left eye. Bilateral multiple retinal capillary hemangiomas were observed at the peripheral retina in both eyes on fundus examination, fluorescein angiography (FAG) and optical coherence tomography (OCT). ERM and associated macular edema (ME) were noted in her left eye. For her left eye, focal laser photocoagulation (PC) was performed 6 times. ME was decreased and her vision improved to 20/25. However, 3 months after the initial visit, her vision decreased to 20/400 accompanied with exacerbated ERM and ME. Therefore, PPV was performed in her left eye. ERM and associated ME were decreased and her vision improved to 20/25 after 18 months. PPV was performed in the right eye immediately after her vision worsened (best corrected visual acuity, BCVA 20/40) and ERM occurred. After 15 months later, vision in her right eye improved to 20/20 and ERM was also decreased. J Korean Ophthalmol Soc 2014;55(6):928-935

Clinical Results of Various Treatments for Retinal Capillary Hemangioma

“…Otherwise, various forms of treatment are available, including laser therapy, cryotherapy, photodynamic therapy, and vitrectomy. However, all those treatments can cause complications such as a temporary increase in the exudate or the formation of an ERM [10,24]. Therefore, treatment should be selected properly according to the patient's individual situation.…”

“…The tumor can be also accompanied by vitreoretinal traction, vitreous hemorrhage, or tractional retinal detachment [3][4][5][6][7]. The decrease of visual acuity seen in RCH is mainly caused by subretinal or intraretinal fluid due to exudation from the proliferating tumor, an epiretinal membrane (ERM), or tractional retinal detachment [7][8][9][10].…”

“…The treatment of RCH is based on tumor size, location, and secondary complications [11,12]. The patient can be observed without treatment or treated with laser therapy, cryotherapy, photodynamic therapy with verteporfin [7,[13][14][15], or vitrectomy [10,[16][17][18][19][20].…”