Juxtapapillary Angioma Treatment Case

By Maria Saornil, MD

Color Photographs: Juxtapapillary Capillary Hemangioma
Color Photographs: Juxtapapillary Capillary Hemangioma

Dr. Soarnil would appreciate suggestions as to treatment options to optimize visual outcome without risk to this 42 year old woman with a juxtapapillary hemangioma.

“This is a case of juxtapapillary capillary hemangioma in a patient with V-H-L Disease, a woman 42 yo. She came to my clinic in February 2007, presenting a VA 20/20 in both eyes, no capillary hemangiomas in the RE and a juxtapapillary hemangioma in the left eye, asymptomatic. After 6 months, she started having visual symptoms and exudates (Top) and we performed TTT treatment. Exudates decreased, but an epiretinal membrane appeared. Hemangioma activity persisted, and a second TTT was performed December 2007, and ERM symptoms worsened and the hemangioma persisted.

View the fluorescein angiogram taken after TTT – treatment

Flourescein Angiography of the juxtapapillary hemangioma
Flourescein Angiography of the juxtapapillary hemangioma

What do you think is the next step? Intravitreal injection of anti- VEGF? Vitreoretinal surgery with endophotocoagulation ? Brachytherapy? Any combination? I will appreciate very much your suggestions.

Best regards,
Maria Saornil

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