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Persistent exudative retinal detachment after photodynamic therapy and intravitreal bevacizumab injection for multiple retinal capillary hemangiomas in a patient with von Hippel-Lindau disease.
[von hippel-lindau disease]
Photodynamic
therapy
(
PDT
)
has
been
used
in
treating
peripheral
retinal
capillary
hemangioma
(
RCH
)
with
satisfactory
results
.
We
report
a
rare
case
of
von
Hippel-
Lindau
(
VHL
)
disease
with
three
large
peripheral
RCHs
,
treated
with
PDT
and
intravitreal
bevacizumab
injection
(
IVB
)
,
who
developed
persistent
bullous
exudative
retinal
detachment
(
RD
)
despite
significant
tumor
regression
.
The
patient
is
a
sporadic
case
of
VHL
disease
,
with
a
de
novo
nonsense
mutation
in
codon
161
with
C
→
T
transition
at
nucleotide
position
694
of
the
VHL
gene
.
Multiple
RCHs
were
noted
in
both
eyes
.
Four
small
RCHs
were
found
in
the
left
eye
and
were
treated
with
laser
photocoagulation
.
Three
large
RCHs
in
the
peripheral
retina
of
the
right
eye
were
complicated
with
cystoid
macular
edema
and
subretinal
fluid
accumulation
.
The
RCHs
were
treated
with
PDT
combined
with
IVB
,
and
bullous
exudative
RD
developed
on
the
second
day
after
treatment
.
Three
months
after
PDT
,
the
tumors
had
regressed
significantly
,
but
exudative
RD
persisted
,
despite
multiple
IVB
and
intravitreal
triamcinolone
acetonide
injection
(
IVTA
)
.
External
drainage
with
sclera
buckling
,
IVB
,
and
IVTA
were
performed
,
and
the
retina
attached
after
surgical
intervention
.
The
application
of
PDT
in
the
treatment
of
RCHs
and
its
possible
complications
are
discussed
.
Diseases
Validation
Diseases presenting
"persistent bullous exudative retinal detachment"
symptom
von hippel-lindau disease
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