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Kapilläre Hämangiome der Netzhaut beim Von-Hippel-Lindau-Syndrom

Neue Therapieansätze

Capillary hemangioma of the retina in cases of von Hippel-Lindau syndrome

New therapeutic directions

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Zusammenfassung

Die thermische Photokoagulation kapillärer Hämangiome beim Von-Hippel-Lindau-Syndrom (VHL-Syndrom) ist die Therapie der Wahl bei kleinen Angiomen. Bei größeren peripheren Angiomen weist die Brachytherapie mit Betaapplikatoren bessere Resultate in Bezug auf Tumorkontrolle und therapiebedingte Komplikationen auf. Die photodynamische Therapie stellt eine therapeutische Alternative dar, wobei eine mögliche Verbesserung der funktionellen Ergebnisse durch Kombination mit intraokularen Medikamenten noch nicht absehbar ist. Die Perkutane Strahlentherapie einschließlich der stereotaktischen Bestrahlung und der Protonenstrahltherapie ist als experimentelle Methode einzustufen. Ein noch ungelöstes therapeutisches Dilemma stellt die Behandlung symptomatischer juxtapapillärer Angiome dar. Die vitreoretinale Chirurgie bleibt fortgeschrittenen Fällen mit traktiver Netzhautablösung oder anders nicht zu behandelnden Tumoren vorbehalten.

Abstract

Thermal photocoagulation of small peripheral angiomas is the treatment of choice for capillary hemangiomas in patients with von Hippel-Lindau disease. Larger peripheral angiomas are better treated with beta-ray brachytherapy resulting in improved results in terms of local tumor control and the side effects of treatment. Photodynamic treatment is an alternative option in the management of capillary hemangiomas of the retina. Further improvement of the treatment results of photodynamic therapy may be achieved by combination with intravitreal drugs. External beam radiation using either stereotactic techniques or proton radiation must be considered as experimental. The treatment of juxtapapillary angiomas is still a therapeutic dilemma. Vitreoretinal surgery should be confined to advanced stages with tractional detachment or when no other treatment option is available to salvage the eye.

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  1. Zentrum für Augenheilkunde , Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Deutschland

    N. Bornfeld

  2. Augen-Zentrum, DRK-Kliniken-Westend, Berlin, Deutschland

    K.-M. Kreusel

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Correspondence to N. Bornfeld.

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Bornfeld, N., Kreusel, KM. Kapilläre Hämangiome der Netzhaut beim Von-Hippel-Lindau-Syndrom. Ophthalmologe 104, 114–118 (2007). https://doi.org/10.1007/s00347-007-1485-1

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