Agarwal Aniruddha, Kumari Neha, Singh Ramandeep
Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India.
Int Ophthalmol. 2016 Oct;36(5):747-50. doi: 10.1007/s10792-016-0183-x. Epub 2016 Jan 27.
Retinal capillary hemangioma (RCH) is strongly associated with von Hippel-Lindau (VHL) disease. Treatment of this sight-threatening condition is often unsatisfactory despite multiple treatment options available. We here describe an interesting case of a 50-year-old male with RCH located in the perifoveal region of the left eye. Subretinal bleed, exudation, and macular edema resulted in progressive deterioration of visual acuity. Fundus photography, fluorescein angiography, and optical coherence tomography (OCT) were used to serially monitor the lesion. After ruling out systemic lesions of VHL disease, the patient was subjected to direct laser photocoagulation of the lesion which resulted in further loss in vision with increase in bleed and exudation. Subsequently, the patient was given 2 monthly intravitreal injections of bevacizumab followed by laser photocoagulation of feeder arteriole. This combination therapy resulted in resolution of exudation, bleed, and macular edema with improvement in visual acuity. Thus, vision-threatening RCH may be safely and effectively treated by means of a combination therapy comprising of intravitreal bevacizumab and feeder vessel treatment.
视网膜毛细血管瘤（RCH）与冯·希佩尔-林道（VHL）病密切相关。尽管有多种治疗选择，但这种威胁视力的疾病的治疗效果往往不尽人意。我们在此描述一例有趣的病例，一名50岁男性，左眼黄斑周围区域患有RCH。视网膜下出血、渗出和黄斑水肿导致视力逐渐下降。通过眼底照相、荧光素血管造影和光学相干断层扫描（OCT）对病变进行连续监测。在排除VHL病的全身性病变后，对该患者的病变进行直接激光光凝治疗，结果导致视力进一步下降，出血和渗出增加。随后，该患者每月接受2次玻璃体内注射贝伐单抗，然后对供养小动脉进行激光光凝治疗。这种联合治疗使渗出、出血和黄斑水肿消退，视力得到改善。因此，通过玻璃体内注射贝伐单抗和供养血管治疗的联合疗法，可以安全有效地治疗威胁视力的RCH。
