Observation on the clinical therapeutic efficacy of retinal angiomas / 中华眼底病杂志

ABSTRACT

Objective To investigate the therapeutic effects of retinal angioma. Methods The clinical data of 16 cases(20 eyes) were retrospectively analyzed, and the patients included 5 males and 11 females of 23.3 yeras old on average. Four cases in this series affected by bilateral retinal angiomas were identified as von Hippel-Lindou disease. The retinal angiomas were divided into 5 stages according to their degrees of developmnet from simple angiom without vessel dilation to feeder vessel dilation and intraretinal exudates, local retinal detachemnt, massive retinal detachment and complication occurrence in proper order. The methods of treatment were laser photocoagulation, trans-scleral cryotherapy and vitreoretinal surgery. The patinets were followed up for 37.8 months on average. Results There were 10 eyes(2 in stage 1, 7 in stage 2, 1 in stage 3)treated with laser photocoagulation, and all of the angiomas were controlled after the treatment. The visual acuity improved in 2 eyes, decreased in 4 eyes, and remained unchanged in 4 eyes. Cryotherapy was performed on 7 eyes(5 in stage 3, 2 in stage 4). The visual deteriortion was found in 5 eyes; and the state of illness was stable in 3 eyes in stage 3 and aggravating in 4 eyes (2 in stage 3, 2 in stage 4). Vitreoretinal surgery was performed on 4 eyes including 2 which had been gi ven photocoagulation, and the visual acuity improved in 2 eyes, decreased in 1 eye, and was unimproved in 1 eye. The visual acuity decreased to no light perception in an untreated eye after 1.5-year follow-up. New angiomas occurred in 3 eyes with Von-Hippel-Lindou disease in the follow-up period. Conclusion Laser photocoagulation is effective in treating the angiomas from stage 1 to 3. Cryotherapy can cause massive exudation and proliferation, and it is only suitable for a few patients in stage 3. The visual prognosis is more favorable in vitreoretinal surgery than other therapies for the patients in stage 4.