Korean J Ophthalmol.  2007 Sep;21(3):178-184. 10.3341/kjo.2007.21.3.178.

Retinal Capillary Hemangioma Treated with Verteporfin Photodynamic Therapy and Intravitreal Triamcinolone Acetonide

• Suh SC
• Jin SY
• Bae SH
• Kim CG
• Kim JW

• KMID: 1099037
• DOI: http://doi.org/10.3341/kjo.2007.21.3.178

Abstract

PURPOSE: To report a case of retinal capillary hemangioma treated with verteporfin photodynamic therapy combined with intravitreal triamcinolone acetonide. METHODS: A 15-year-old female presented with metamorphopsia in the left eye for 7 days. Examination showed peripheral endophytic retinal capillary hemangioma, macular edema, and a best-corrected visual acuity of 20/50. The hemangioma and macular edema were treated with verteporfin photodynamic therapy and intravitreal triamcinolone acetonide. RESULTS: After 5 months of follow-up, involution of the hemangioma, reduction of macular edema, decrease of the feeder and draining vessel diameter, and improvement of best-corrected visual acuity to 20/25 was seen. CONCLUSIONS: This verteporfin photodynamic therapy combined with intravitreal triamcinolone acetonide appeared to cause involution of the hemangioma with reduction in macular edema and improvement in visual acuity.

Keyword

Retinal Capillary Hemangioma; Triamcinolone Acetonide; Vertepofin Photodynamic Therapy

MeSH Terms

Adolescent
Female
Fundus Oculi
Glucocorticoids/*administration & dosage/therapeutic use
Hemangioma, Capillary/diagnosis/*drug therapy
Humans
Injections
*Photochemotherapy
Photosensitizing Agents/*therapeutic use
Porphyrins/*therapeutic use
Retinal Neoplasms/diagnosis/*drug therapy
Tomography, Optical Coherence
Triamcinolone Acetonide/*administration & dosage/therapeutic use
Ultrasonography
Vitreous Body

Figure

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  Fig. 1 First visit (pre-treatment). (A) The left fundus reveals mild macular edema and hard exudates with tortuous dilated vessel. (B) Circumscribed endophytic retinal capillary hemangioma appears at the 5 o'clock periphery with a prominent dilated and tortuous feeding artery and draining vein. (C, D) Progressive and complete filling of the hemangioma and the retinal vein becomes prominent. (E) OCT image demonstrating cystic macular edema at first visit. (F) B-scan shows a well-demarcated endophytic retinal lesion without choroidal effects.

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  Fig. 2 Optical coherence tomogram images. (A) OCT image demonstrating cystic macular edema at first visit. (B) Worsened cystic macular edema after PDT treatment. (C) 12 days after PDT, improvement of cystic intraretinal edema after intravitreal triamcinolone acetonide. (D) 22 days after PDT, OCT image of the forvea shows restoration of the foveal contour.

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  Fig. 3 12 days after PDT. (A) The feeder and draining vessel diameters decreased. (B) The retinal capillary hemangioma underwent partial involution (approximately 2.5 DD). The whitish mass is triamcinolone acetonide.

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  Fig. 4 22 days after PDT. (A) The left fundus reveals decreased macular edema and hard exudates with a straighter vessel. (B) The retinal capillary hemangioma regressed approximately 1.5 DD. (C, D) Fluorscein angiogram demonstrating decreased early filling and late leakage of the hemangioma. (E) B-scan showing decreased endophytic retinal lesion.

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  Fig. 5 3 months after PDT. (A) The macular hard exudate and edema improved. (B) The retinal capillary hemangioma regressed approximately 1.0 DD.

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  Fig. 6 5 months after PDT. (A) The macular hard exudate and edema nearly disappeared. (B) Fluorescein angiogram demonstrating reduced fluorescence and leakage associated with the lesion.

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