| 본문 : Purpose: To report a case of solitary foveal capillary hemangioma managed by surgery
Case summary: A 52-year-old woman with a history of hypertension had been experiencing decreased visual acuity in her right eye for 1 week. At the initial visit, corrected visual acuity of the right eye was 0.05 and that of the left eye was 1.0. Funduscopic examination showed superior temporal retinal hemorrhage with foveal hemangioma of the right eye and a foveal scar with retinal pigment epithelial atrophy. Fluorescein angiography, indocyanine green angiography, and optical coherence tomography were performed on both eyes. Foveal vessel rupture and leak with hyporfluorescence, delayed arteriovenous (A-V) crossing in the superiotemporal area, sub-internal limiting membrane (ILM) hemorrhage, and foveal capillary hemangioma with collateral vessel in the right eye were found. Over a 2-week followup, the sub-ILM hemorrhage persisted. So 2 weeks after follow up, pars plana vitrectomy, phacoemulsification, posterior chamber lens insertion, membrane peeling, and endolaser were performed. 2 months after surgery, corrected visual acuity of the right eye was 0.2 and funduscopy findings showed improvement. No specific complication was observed. 3 months after surgery, corrected visual acuity of the right eye was 0.03 and a small amount of subretinal fluid was observed. Intravitreal bevacizumab injection was administered. This improved the corrected visual acuity to 0.1, which was maintained for 6 months.
Conclusions: Solitary retinal capillary hemangioma is associated with Von Hippel-Lindau (VHL) syndrome in 46% of the cases. More than 90% of such patients are under 10 years of age. According to reports, retinal capillary hemangioma occurs around the peripheral retina or optic nerve head, regardless of the presence of VHL. However, in this case, capillary hemangioma occurred on fovea, which was accompanied by a decrease in visual acuity. In such cases, visual improvement can be accomplished through surgery.
|