DOI: https://doi.org/10.22263/2312-4156.2025.3.76
I.I. Malinouskaya1, Koen van Overdam2, T.A. Imshanetskaya1, A.N. Dudich1, N.K. Karalkova2
Retinal capillary hemangioblastoma: management tactics of patients based on a clinical case
1The Institute for Advanced Training and Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”, Minsk, Republic of Belarus
2Erasmus Medical Center, Rotterdam, the Netherlands
3Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2025;24(3):76-88.
Abstract.
Objectives. To present a clinical case of retinal capillary hemangioblastoma (RCH) excision before the development of pronounced secondary retinal complications, which prevented a further visual function decrease.
Material and methods. A clinical case of a patient with isolated RCH is described. The patient underwent multimodal ophthalmological examinations, including slit-lamp biomicroscopy, fundus examination with a fundus lens, color fundus photography, ultrasound (B-scan), optical coherence tomography (OCT) and fluorescence angiography. In order to exclude Von Hippel–Lindau disease, the patient had an ultrasound of the abdominal, brain, and spinal cord MRI and genetic test. According the examination results the diagnosis was confirmed. Closed vitrectomy (CVE) with removal of the RCH was performed using the original Koen van Overdam technique.
Results. There were no post-operative complications. Two months after the RCH with subsequent extrusion of silicone oil the best-corrected visual acuity increased up to 0,6 and remained stable during the three-year follow-up. The OCT of the central retinal zone revealed complete resorption of the sub- and intraretinal fluid with insignificant residual amount of hyper-reflective deposits in the outer layers. The partial damage of the ellipsoid zone in the foveolar area explained the absence of maximal visual acuity in patients. The OCT of the excision site showed complete retinal attachment without exudative and fibrotic proliferative changes. The fluorescein angiography two months after the removal of silicone oil confirmed the absence of new RCHs and exudation.
Conclusions. This clinical case demonstrates the possibility of vitrectomy with the RCH excision without any intra- and postoperative complications. Performing surgeries, according to the described steps, allows preventing the development of proliferative vitreoretinopathy and retinal detachment and avoiding further loss of visual functions.
Keywords: retinal capillary hemangioblastoma, Hippel-Lindau disease, pars plana vitrectomy, vitreous cortex remnants, proliferative vitreoretinopathy, optical coherence tomography.
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Submitted 10.04.2025
Accepted 13.06.2025
Information about authors:
Inna I. Malinouskaya – Candidate of Medical Sciences, associate professor of the Chair of Ophthalmology, The Institute for Advanced Training and Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”, https://orcid.org/0000-0003-4850-3910, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
Koen van Overdam – vitreoretinal surgeon, MD, PhD, Erasmus Medical Center;
T.A. Imshanetskaya – Doctor of Medical Sciences, professor, Head of the Chair of Ophthalmology, the Institute for Advanced Training and Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”;
O.N. Dudich – Candidate of Medical Sciences, associate professor of the Chair of Ophthalmology, the Institute for Advanced Training and Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”, https://orcid.org/0009-0004-6554-3230
N.K. Karalkova – Candidate of Medical Sciences, associate professor, Head of the Chair of Ophthalmology & Otorhinolaryngology, Vitebsk State Order of Peoples’ Friendship Medical University.
