Multimodal Approach for Management of Retinal Angioma: A Case Series

Abstract

Purpose: To evaluate outcomes of multi modal approach in management of Retinal Angioma. Material and Methods: Medical reports of 15 eyes of 12 patients having retinal angioma presented over a period of 12 years were retrospectively analyzed. Age, gender, presenting complaint, general physical examination and neurological examination findings, initial Visual Acuity, eye involved, tumor location, growth pattern, ocular complications were noted. Fundus photographs and FFA, OCT at initial visit as well as those taken during follow-up and final visual acuity were noted. CT/MRI brain and abdominal ultrasound reports were reviewed. Any pedigree association with von-Hipple-Lindau disease was recorded. Results: Records of 15 eyes of 12 patients with retinal angioma were reviewed including 7 males and 5 females. Mean age of presentation was 27.7 yrs. Initial vision was 6/6 –6/18 in 27%, 6/24 –6/60 in 20%, 5/60 –3/60 in 27%, <2/60 in 26%. Laser was given as initial treatment in 8 eyes in which 4 eyes received intravitreal anti VEGF along with laser. Cryotherapy was done in 2 eyes and VR surgery was done in 5 patients. At final follow-up all patients had stable tumor and resolution of exudates and macular edema and vision was better than 6/18 in 73% 6/18 - 6/60 in 7% and less than 3/60 in 7%. Conclusion: Early diagnosis and treatment of retinal angiomas with multimodal approach yields good visual outcome. If untreated the tumors may eventually have exudative RD and have a poor visual prognosis even with vitreoretinal surgery.