2014 - 5 Issue

Case report

The Use of Anti-VEGF Preparations and PDT in the Treatment of Retinal Juxtapapillary Hemangioma – A Case Report

Veronika Matušková ORCID
Daniela Vysloužilová ORCID

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Published in Czech and Slovak Ophtalmology: 2014 - 5

Published on website: 18.09.2014

Keywords: Capillary hemangioma, PDT, juxtapapillary hemangioma, bevazicumab, verteporfine, von Hippel – Lindau disease

Summary

Aim: The aim of this paper is to present clinical experience with the therapy of retinal juxtapapillary hemangioma using the intravitreal application of anti-VEGF substance (bevacizumab) and photodynamic therapy (PDT) with verteporfine (Visudyne).

Material and methods: The authors present a case of a 34 years old male patient with diagnosed retinal hemangioma localized on the optic disc. Subjectively, the patient noticed decrease of vision, and during the clinical examination, the edema in the macula region spreading from the hemangioma with hard exsudates was found; the best-corrected visual acuity (BCVA) was 4/20 (0.2).

Results: First, the patient was treated by intravitreal applications of bevacizumab; after the first application, the edema from the macula subsided, and the best-corrected visual acuity improved to 4/12 (0.33). After one month of the first application, a recurrence of the edema occurred and other two injections of bevacizumab were applied; despite this treatment, further worsening of the exsudation from the hemangioma and worsening of the BCVA to 4/32 (0.125) occurred. Subsequently, one session of photodynamic therapy with verteporfine was held. After this therapy, the finding on the posterior ocular pole was stabilized; the BCVA was 4/40 (0.1). Even one year after the
PDT therapy, no recurrence was present.

Conclusion: According to our experience, the PDT with Visudyne appears as promising therapy method of juxtapapillary capillary hemangiomas. The PDT decreases the leaking of the fluid from hemangioma and decreases the size of hemangioma.

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