Nabih O, Hamdani H, El Maaloum L, Allali B, El Kettani A
Medical Resident at Pediatric Ophthalmology Department, Hopital 20 Aout, 1953, Casablanca, Morocco.
Professor- Pediatric Ophthalmology Department, Hopital 20 Aout, 1953, Casablanca, Morocco.
Ann Med Surg (Lond). 2022 Jan 25;74:103292. doi: 10.1016/j.amsu.2022.103292. eCollection 2022 Feb.
Von Hippel-Lindau disease (VHL), also known as Von Hippel-Lindau syndrome, is a rare genetic disorder with multisystem involvement. It is characterised by the development of multiple vascularised tumours, particularly cerebellar, retinal and/or visceral. The disease can occur at any age and usually starts with retinal hemangioblastomas.
We report the case of a 45-year-old female patient with no particular pathological history, who. consulted the ophthalmology department for a change of optical correction.The funds examination showed an uncomplicated bilateral hemangioma with no other associated signs. Fluorescein angiography confirmed the diagnosis by showing in the left eye a multiple retinal hemangioma visible in the mid-periphery facing the branches of the superior temporal arches. The brain MRI showed a multifocal hemangioblastoma in the posterior cerebral fossa. A renal ultrasound returned normal. The patient had undergone photocoagulation of the retinal lesions to avoid any complications.
The German ophthalmologist Eugen von Hippel first described angiomas in the eye. The term Von Hippel-Lindau disease was first used in 1936; however, its use became common only in the 1970s.Tumours called hemangioblastomas are characteristic of von Hippel-Lindau syndrome. These growths are made of newly formed blood vessels and occurs in the periphery of the retina. Spontaneous progression occurs leading to visual impairment as a result of maculopathy or exudative retinal detachment.Early recognition and treatment of specific manifestations of VHL can substantially decrease complications and improve quality of life.Conventional treatment of the retinal hemangioblastomas is laser photocoagulation or cryotherapy depending on the location and size of the lesions. It must be based on the patient's visual symptoms and tumor progression.
Management of patients with VHL disease often requires a multidisciplinary approach. The role of the ophthalmologist is important in the management of this condition since the ocular involvement may be indicative of the disease.
希佩尔-林道病(VHL),也称为希佩尔-林道综合征,是一种累及多系统的罕见遗传性疾病。其特征是出现多个血管化肿瘤,尤其是小脑、视网膜和/或内脏肿瘤。该疾病可发生于任何年龄,通常始于视网膜血管母细胞瘤。
我们报告一例45岁女性患者,无特殊病史,因验光矫正变化就诊于眼科。眼底检查显示双侧单纯性血管瘤,无其他相关体征。荧光素血管造影通过显示左眼颞上弓分支相对的中周边部可见多个视网膜血管瘤,从而确诊。脑部磁共振成像显示在后颅窝有多灶性血管母细胞瘤。肾脏超声检查结果正常。该患者已接受视网膜病变的光凝治疗以避免任何并发症。
德国眼科医生欧根·冯·希佩尔首次描述了眼部血管瘤。希佩尔-林道病这一术语于1936年首次使用;然而,直到20世纪70年代才普遍使用。血管母细胞瘤是希佩尔-林道综合征的特征性肿瘤。这些肿瘤由新形成的血管构成,发生于视网膜周边部。由于黄斑病变或渗出性视网膜脱离,会出现自然进展导致视力损害。早期识别和治疗VHL的特定表现可显著减少并发症并改善生活质量。视网膜血管母细胞瘤的传统治疗方法是根据病变的位置和大小进行激光光凝或冷冻疗法。治疗必须基于患者的视觉症状和肿瘤进展情况。
VHL病患者的管理通常需要多学科方法。眼科医生在这种疾病的管理中起着重要作用,因为眼部受累可能提示该病。