A case of choroidal hemangioma with bullous exudative retinal detachment treated successfully by transpupillary thermotherapy

Background: Choroidal hemangioma associated with bullous retinal detachment may be difficult to treat, due to varying results with conventional laser photocoagulation, radiotherapy, or surgical drainage. Here we report on a case of extensive bullous retinal detachment secondary to circumscribed choroidal hemangioma that was resolved after combined treatment with vitrectomy, silicone oil tamponade, and transpupillary thermotherapy.

Methods: A 29-year-old woman presented with a large choroidal hemangioma in her right eye associated with serous retinal detachment. The tumor measured 8 disc diameters in size and was located in the inferotemporal macula, abutting the fovea.

Results: Laser photocoagulation of the tumor was unsuccessful in inducing absorption of subretinal fluid. Because of progressive bullous retinal detachment, surgery was performed consisting of external drainage of subretinal fluid, vitrectomy, endolaser photocoagulation of the tumor, and silicone oil tamponade. The silicone oil was removed four weeks postoperatively at which time almost complete resolution of the retinal detachment was observed. However, retinal detachment recurred eight weeks later, and transpupillary thermotherapy was then applied to the tumor. By four weeks after transpupillary thermotherapy, total reabsorption of subretinal fluid, visual acuity improvement, and decreased height of the choroidal hemangioma were noted.

Conclusions: Transpupillary thermotherapy is an effective treatment for serous retinal detachment associated with choroidal hemangioma.