Transpupillary thermotherapy for retinal capillary hemangioma in von Hippel-Lindau disease

Retinal capillary hemangiomas are a common manifestation of von Hippel-Lind au disease. We report the treatment of a peripapillary retinal capillary he mangioma in the left eye of a 30-year-old woman with this condition, using infrared diode laser transpupillary thermotherapy (TTT). The hemangioma was evaluated before and after treatment by ophthalmoscopy, fundus fluorescein angiography, and Doppler ultrasonography. Infrared diode laser TTT was del ivered over 3 sessions during a period of 22 weeks, resulting in an improve ment in visual acuity from counting fingers to 6/24 and a marked decrease i n exudates surrounding the hemangioma. Doppler ultrasonography demonstrated a decrease in intralesional blood flow from 7 cm per second to less than 3 cm per second, together with a decrease in the size of the lesion. Infrare d diode laser TTT provides a useful modality in the treatment of retinal ca pillary hemangiomas, and may be particularly favorable for peripapillary le sions because of its relatively nondestructive characteristics.