VHL HEMANGIOBLASTOMA: ARGON LASER vs ANTI-VEGF Gonzales Farro KP, García Saénz MC, Santiago Balsera H, Fernández García JL.

AIM To present the case of a patient with Von Hippel Lindau disease that developed retinal pathology.

CLINICAL CASE A 46-year-old male with Von Hippel Lindau disease and systemic tumors including CNS was referred to ophthalmology. VA: 20/20. Both optic nerves: swollen with hemorrhages. Left eye: peripheral nasal-superior hemangioblastoma with bleeding. RIGHT LEFT

RESULTS- FOLLOW-UP Left eye: Argon laser was performed surrounding the peripheral lesion. After some months of bleeding, it remained stable. At time 3 Months 6 Months

RESULTS- FOLLOW-UP Two years later, he developed in the right eye new active vessels in papilla. Also, macular traction. The VA remained 20/20. We performed several Ranibizumab inyections for papillary neovascularization.

DISCUSSION Difficult to decide the best treatment: Argon laser, criotherapy , anti-VEGF, PDT or vitrectomy can be considered. Consider general status of patient.

CONCLUSIONS Small retinal capillary hemangioblastoma can be treated with argon laser photocoagulation in most locations. Anti-VEGF treatment can be an adjuvant therapy associated with other procedures with a central location. BIBLIOGRAFÍA: Schmid S, Gillessen S, Binet I. Management of von Hippel-Lindau Disease: An interdisciplinary Review. Oncol Res Treat 2014;37:761-771 Mariotti C, Giovannini A, Reibladi M, Nicolai M, Saitta A. 25-Gauge Vitrexctomy Combined with Half-Fluence Photodynamic Therapy for the Treatment of Juxtapapillary Retinal Capillary Hemangioma: A case report. Case Rep Ophthalmol 2014;5:162-167 Chelala E, Dirani A, Fadlallah A. Intravitreal anti-VEGF injection for the treatment of progressive juxtapapillary retinal capillary hemangioma. Clinical Ophthalmology 2013;7:2143-2146 Singh A, Nouri M, Shields C, Shields J, Perez N. Treatment of retinal capillary hemangioma. American Academy of Ophthalmology 2002;109:1799-1806