J Korean Ophthalmol Soc.  2014 Jun;55(6):928-935.

A Case Report of Primary Vitrectomy in Multiple Bilateral Retinal Capillary Hemangiomas Accompanying Epiretinal Membrane

• Baek SK
• Jin SY
• Lee YH
• Lee TG

Abstract

PURPOSE
To report the clinical result of pars plana vitrectomy (PPV) as the primary treatment in a patient with multiple bilateral retinal capillary hemangiomas (RCH) accompanying epiretinal membrane (ERM).
CASE SUMMARY
A 17-year-old female patient visited our clinic for decreased bilateral vision 4 days in duration. At the first visit, the vision in her right eye was 20/25 and, 20/100 in her left eye. Bilateral multiple retinal capillary hemangiomas were observed at the peripheral retina in both eyes on fundus examination, fluorescein angiography (FAG) and optical coherence tomography (OCT). ERM and associated macular edema (ME) were noted in her left eye. For her left eye, focal laser photocoagulation (PC) was performed 6 times. ME was decreased and her vision improved to 20/25. However, 3 months after the initial visit, her vision decreased to 20/400 accompanied with exacerbated ERM and ME. Therefore, PPV was performed in her left eye. ERM and associated ME were decreased and her vision improved to 20/25 after 18 months. PPV was performed in the right eye immediately after her vision worsened (best corrected visual acuity, BCVA 20/40) and ERM occurred. After 15 months later, vision in her right eye improved to 20/20 and ERM was also decreased.

Keyword

Epiretinal membrane; Laser photocoagulation; Retinal capillary hemangioma; Vitrectomy

MeSH Terms

Adolescent
Epiretinal Membrane*
Female
Fluorescein Angiography
Hemangioma, Capillary*
Humans
Light Coagulation
Macular Edema
Retina
Retinaldehyde*
Tomography, Optical Coherence
Visual Acuity
Vitrectomy*
Retinaldehyde

Figure

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  Figure 1. First visit (pre-treatment). (A, B) Multiple orange-red colored round masses < 2.5 DD with afferent and efferent vessels were observed at the peripheral retina in both eyes. (B) Epiretinal membrane (ERM) was attached to the optic disc and macula. (C, D) Circumscribed multiple retinal capillary hemangiomas are in the periphery with a prominent dilated and tortuous feeding artery and draining vein. (E, F) Optical coherence tomogram (OCT) of the fovea demonstrated normal features (OD) and intraretinal edema (OS).

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  Figure 2. (OS) Fundus photography (A) and optical coherence tomogram (OCT) images (B). Macular edema (ME) and epiretinal membrane (ERM) of the fovea was decreased (6th cessions after focal laser PC).

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  Figure 3. (OS) Fundus photography (A) and optical coherence tomogram (OCT) images (B). Macular edema (ME) and epiretinal membrane (ERM) was exacerbated around the laser scars (7th cessions after focal laser PC).

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  Figure 4. Fundus photography (A) and optical coherence tomogram (OCT) images (B). Exacerbated epiretinal membrane (ERM) was noticed compared to the first visit.

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  Figure 5. Last visit (18 months after left eye surgery, 15 months after right eye surgery). (A, B) Fundus photography images. Remained stable lesion was inspected at the last visit. (C, D) Fluorescein angiogram demonstrating reduced fluorescence and leak-age associated with the lesion. (E, F) Optical coherence tomogram (OCT) of the fovea demonstrated decreased epiretinal membrane(ERM) and macular edema (ME).

Reference

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