Hemangiomas Definition

Capillary hemangiomas or hemangioblastomas occur in angiomatosis retinae (von Hippel-Lindau disease).

— Von Hippel-Lindau disease.

— Von Hippel-Lindau disease.

Fig. 12.37 a A hemangio-blastoma (arrow) in von Hippel-Lin-dau disease with enlarged retinal arteries and veins and retinal detachment with hard exudate (arrowhead).

b Corresponding fluorescein angiogram.

Fig. 12.37 a A hemangio-blastoma (arrow) in von Hippel-Lin-dau disease with enlarged retinal arteries and veins and retinal detachment with hard exudate (arrowhead).

b Corresponding fluorescein angiogram.

12.8 Retinal Tumors and Hamartomas 357 Epidemiology: Hemangiomas are rare.

Etiology: These are benign congenital changes. There may be an autosomal dominant inheritance.

Symptoms: Loss of visual acuity will result where exudative retinal detachment develops.

Findings and diagnostic considerations: Retinal hemangiomas are characterized by thickened tortuous arteries and veins (Figs. 12.37 a and b). Bilateral changes are present in 50% of all patients.

Differential diagnosis: Coats' disease, branching retinal hemangiomas in Wyburn-Mason syndrome, and cavernous hemangiomas should be considered. Cerebral hemangiomas, renal cysts, hypernephromas, and pheochro-mocytomas should also be excluded.

Treatment: Retinal hemangiomas may be treated by laser or cryocautery therapy. However, exudative retinal detachment will develop as the treatment increases this risk.

Clinical course and prognosis: The disorder is gradually progressive. The prognosis for visual acuity is poor in the disorder where retinal detachment develops.

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