Background: We compared therapeutic outcomes in two cases of juxtapapillary capillary hemangiomas associated with von Hippel-Lindau disease.
Cases: Case 1 was a 47-year-old man whose left eye was blind due to proliferative vitreoretinopathy. Visual acuity of the right eye was 1.2. No exudative change was found, but the juxtapapillary retinal hemangioma was enlarged. Three injections of intravitreal bevacizmab were not effective and laser photocoagulation was performed. Humphry microperimetry revealed a decreased sensitivity corresponding to the papillo-macular bundle damage. Vision was restored with regression of the retinal hemangioma. Case 2 was a 36-year-old woman with bilateral visual acuity of 1.2. The right eye had an inferior juxtapapillary retinal hemangioma at the optic disc surrounded by exudative retinal detachment. Laser photocoagulation, intravitreal injection of bevacizmab, transpapillary thermotherapy, photodynamic therapy, and vitrectomy were performed, but vision decreased to 0.02.
Conclusions: Photocoagulation in the early stage of juxtapapillary hemangioma before development of exudative detachment may preserve visual acuity.