Retinal vascular proliferation as an ocular manifestation of von Hippel-Lindau disease.
OBJECTIVE
To describe the features, natural history, and management of an unusual manifestation of ocular von Hippel-Lindau disease in the form of fine vascular proliferation.


METHODS
Case series of 14 patients with definite or presumed von Hippel-Lindau disease.


RESULTS
Retinal vascular proliferation consisting of fine superficial vessels was found in 16 eyes of 14 patients with von Hippel-Lindau disease. The lesion was often found in a juxtapapillary location and associated with a fibrovascular component and/or a macular epiretinal membrane. In cases with follow-up (12 patients; mean [SD] follow-up, 10.9 [7.5] years), the lesion was stable in 7 of 13 eyes but showed growth and progression resulting in vision loss in the remainder. In 5 eyes, surgical intervention with pars plana vitrectomy, membrane peel, and excision of the fibrovascular lesion resulted in visual improvement in all of the cases.


CONCLUSIONS
Ocular von Hippel-Lindau disease can uncommonly manifest as vascular proliferation that consists of fine, superficial, juxtapapillary vessels that are often associated with fibrovascular proliferation and epiretinal membrane formation. The natural history of this lesion is variable and can result in vision loss from tractional effects in progressive cases. Vision-threatening cases may be successfully managed by surgical excision.
Wong
Wai T
WT
Office of Scientific Director, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Yeh
Steven
S
Chan
Chi-Chao
CC
Kalina
Robert E
RE
Kinyoun
James L
JL
Folk
James C
JC
Coleman
Hanna R
HR
Chew
Emily Y
EY
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D005355:Fibrosis; D005451:Fluorescein Angiography; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012171:Retinal Vessels / Q000473:pathology* / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy; D006623:von Hippel-Lindau Disease / Q000150:complications* / Q000175:diagnosis / Q000601:surgery