[A case of von Hippel-Lindau disease with papillary capillary hemangioma treated by photodynamic therapy].

BACKGROUND

Laser photocoagulation of papillary hemangioma in von Hippel-Lindau disease often causes visual loss. Therefore, we applied photodynamic therapy for one patient.

CASE: A 36-year-old male had 3.2 x 2.6 mm capillary hemangioma of the optic disc associated with a fibrovascular membrane and exudative retinal detachment involving the whole macular area in his left eye. His visual acuity was 0.08.

TREATMENT: Two days after the intravenous injection of 2 mg/kg of hematoporphyrin derivatives, the eye was irradiated with a dye laser of 630 nm wavelength, with irradiance of 637 mW/cm2 and a radiant exposure of 150-250 J/cm2. The exudative retinal detachment and hemorrhage in the tumor increased from day 1, but the tumor and exudative changes began to resolve after 3 weeks. The fibrovascular membrane was removed by vitrectomy. Three years after the treatment, the tumor was completely resolved, but the patient's visual acuity was 0.1 due to atrophy of the optic nerve and pigment epithelium of the macula.

CONCLUSION

Although further investigation on optimal radiance avoiding damage to the optic nerve is still needed, photodynamic therapy is a promising therapeutic option for papillary hemangioma.