Title
RETINAL CAPILLARY HEMANGIOMA WITH SEROUS RETINAL DETACHMENT
Introduction
Retinal hemangioblastoma (capillary hemangioma) is a rare tumor, stimulated by vascular endothelial growth factor (VEGF) secreted by stromal tumor cells and with a more common presentation in young adults. It may appear as an isolated tumor or as part of von Hippel-Lindau's disease (VHL), described in 1904. It presents, initially, as a small, well-defined reddish lesion. The well-established tumor, on the other hand, appears as a round orange-reddish mass, followed by dilatation and tortuosity of vessels, usually superotemporal or inferotemporal. Angiofluoresceinography shows early hyperfluorescence, with late leakage.
Methods
Case report carried out at the Suel Abujamra Institute in 2019 of a 31 year-old patient with the complaint of low visual acuity in the left eye (20/400) for 15 days. Tests were carried out for the case and the following 12 months.
Results
The initial fundscopy of the patient showed hard peripheral exudates, detachment of the macular serous retina and vasoproliferative lesion at the end of the superior temporal arch. Argon laser photocoagulation was performed on the left eye, in order to seal tumor nourishing vessels. After 60 days visual acuity improved to 20/100. In addition, the patient is currently waiting an application of bevacizumab. Other therapeutic modalities are also possible, such as cryotherapy, brachytherapy and vitreoretinal surgery.
Discussion
Hemangioblastomas should be investigated in patients with risk factors or who present with retinal detachment. The low visual acuity can be justified by the formation of exudates around the tumor or in the macula. Other common complications are bleeding and leakage, mainly due to major macular edema and retinal detachment, which, in most cases, is rhegmatogenic or traction.
Keywords
Hemagioblastoma, capillary hemangioma, retinal detachment
Area
CLINICAL CASE
Authors
Beatriz Mello Mencaroni, Paulo Henrique Horizonte, Leandro Pocay Alves da Silva, André Macedo V. Gomes, Raimunda Cristina M. F. de Oliveira, Carolina Maria Barbosa Lemos, Nathália Nishiyama Tondelli, Gabriella Marranghello Mingione