Abstract

Volume.123 Number.11

Original article : Case report

A Case of Circumscribed Choroidal Hemangioma with Severe Exudative Retinal Detachment Successfully Treated with Vitrectomy and Silicone Oil Tamponade Followed by Photodynamic Therapy
Setsuko Kawakami, Yoshihiro Wakabayashi, Hiroshi Goto
Department of Ophthalmology, Tokyo Medical University

Background: In choroidal hemangioma with severe exudative retinal detachment, it is often difficult to suppress tumor activity with treatment. Here, we report a case of circumscribed choroidal hemangioma with exudative retinal detachment that improved with vitrectomy and silicone oil tamponade, followed by photodynamic therapy performed immediately after retinal reattachment.
Case: A 51-year-old woman presented with a circumscribed choroidal hemangioma measuring 9 mm in diameter located on the left temporal side of the macula, with extensive exudative retinal detachment and choroidal detachment present since the initial diagnosis. For treatment, we performed vitrectomy and drainage of subretinal fluid from an intentional tear to reattach the retina, followed by fluid-air exchange and silicone oil tamponade. Four days after the surgery, photodynamic therapy was performed for the choroidal hemangioma. Thereafter, since exudative retinal detachment continued to regress and the elevated lesion in the tumor had flattened, the silicone oil was removed 2 months after photodynamic therapy. No recurrence of the tumor and exudative retinal detachment was observed during the follow-up of 2 years.
Conclusion: For circumscribed choroidal hemangiomas with severe exudative retinal detachment, performing vitrectomy to reattach the retina followed by photodynamic therapy under silicone oil tamponade helps in reducing choroidal hemangioma activity and preserving visual function.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 1071-1077, 2019.

Key words
Circumscribed choroidal hemangioma, Exudative retinal detachment, Vitrectomy, Photodynamic therapy, Silicone oil tamponade
Reprint requests to
Setsuko Kawakami, M.D. Department of Ophthalmology, Tokyo Medical University. 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan