Gallenga Carla E, Zeppa Lucia, De Pascale Ilaria, Salerno Giulio, Tassinari Paolo, Perri Paolo, Zeppa Lucio
UOS Vitreo-retina Unit, University Hospital, Ferrara, Italy.
UOC Ophthalmology Unit, "San Giuseppe Moscati" Hospital, Avellino, Italy.
Retin Cases Brief Rep. 2025 Mar 1;19(2):205-209. doi: 10.1097/ICB.0000000000001550.
Retinal capillary hemangioblastoma is present in about half of the carriers of the von Hippel-Lindau gene mutation and can lead to the evolution of blindness. Herewith is a proposal for surgical intraretinal feeder vessel ligature to induce ischemia of the phakoma and to resolve the exudative secondary retinal detachment, with satisfying results at the 6-month follow-up endpoint.
The patient underwent a chandelier-assisted 23-gauge pars plana vitrectomy with valved trocars. A bimanual transretinal ligature of the feeder vessel of hemangioblastoma was performed, followed by localized endolaser to ablate the surrounding retina and capillaries, and a polydimethylsiloxane 1,000 final tamponade. After 3 months, exchange of polydimethylsiloxane/air/balanced salt solution, phacoemulsification, and in-the-bag intraocular lens implantation were performed.
At the sixth month, fundus fluorescein angiography showed a significant reduction of blood flow in the phakoma. The final best-corrected visual acuity was 6/6 (9 lines gain obtained compared with the baseline time).
This surgical technique seems to be effective and promising for the treatment of von Hippel-Lindau retinal capillary hemangioblastomas and their related retinal complications.
视网膜毛细血管瘤存在于约一半的冯·希佩尔-林道基因突变携带者中，可导致失明。本文提出一种手术方法，即视网膜内供血血管结扎术，以诱导错构瘤缺血并解决渗出性继发性视网膜脱离，在6个月随访终点时取得了满意的结果。
患者接受了带阀门套管的吊灯辅助23G经平坦部玻璃体切除术。对毛细血管瘤的供血血管进行双手经视网膜结扎，随后进行局部视网膜激光光凝以消融周围视网膜和毛细血管，并进行1000厘泊的聚二甲基硅氧烷最终填塞。3个月后，进行聚二甲基硅氧烷/空气/平衡盐溶液置换、超声乳化和囊袋内人工晶状体植入。
在第6个月时，眼底荧光血管造影显示错构瘤内血流显著减少。最终最佳矫正视力为6/6（与基线时间相比提高了9行）。
这种手术技术对于治疗冯·希佩尔-林道视网膜毛细血管瘤及其相关的视网膜并发症似乎是有效且有前景的。
