Therapeutic options for capillary papillary hemangiomas

Purpose: To describe the results and therapeutic complications of treatment of papillary capillary hemangiomas over the last 13 years. Design: Retrospective, noncomparative, interventional case series. Participants: Five cases of unilateral capillary papillary hemangiomas were reviewed. Three patients had von Hippel-Lindau disease, and two had no ass ociated familial or systemic disease. Methods: Two patients were treated with argon green laser, one patient rece ived argon green and diode photocoagulation, and two patients underwent arg on green photocoagulation and diode transpupillary thermotherapy (TTT); two eyes also underwent vitreoretinal surgery. Follow-up ranged from 1 to 13 y ears. Main Outcome Measures: The presence of exudative retinal detachment associa ted with the activity of the hemangioma and the visual acuity were the two main parameters. Results: Prompt argon green laser treatment was the most effective therapy; TTT was ineffective. Vitreoretinal surgery, transscleral drainage, and arg on endolaser photocoagulation in one case resolved bullous retinal detachme nt secondary to tumor exudation, Pretreatment visual acuity (VA) levels ran ged from 20/25 to counting fingers; posttreatment VA levels ranged from 20/ 25 to light perception. Conclusions: If left untreated, papillary hemangiomas may evolve to exudati ve retinal detachment and marked VA decreases, Although we have not establi shed an ideal therapy, we recommend appropriate treatment on diagnosis. Clo se follow-up and multiple treatments with argon laser are likely the best t herapeutic course. Ophthalmology 2000;107:48-54 (C) 2000 by the American Ac ademy of Ophthalmology.