Optical Coherence Tomography Angiography-Navigated Laser Photocoagulation of Retinal Hemangioblastomas in Patients With von Hippel-Lindau Disease.

Autor:	Laich Y; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany., Farassat N; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany., Grewing V; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany., Boehringer D; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany., Bucher F; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany., Maloca PM; Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.; Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom., Reinhard T; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany., Lang SJ; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany.; Department of Ophthalmology, University Hospital Brandenburg, Brandenburg Medical School, Brandenburg an der Havel, Germany., Agostini H; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany., Reich M; Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany.; Augenärzte am Städel, Medical Practice for Ophthalmology, Frankfurt, Germany.
Jazyk:	angličtina
Zdroj:	Translational vision science & technology [Transl Vis Sci Technol] 2024 Jul 01; Vol. 13 (7), pp. 8.
DOI:	10.1167/tvst.13.7.8
Abstrakt:	Purpose: To describe optical coherence tomography angiography (OCTA)-guided navigated laser photocoagulation (LP) using the Navilas Laser System for treating retinal hemangioblastomas (RHs) associated with von Hippel-Lindau disease (VHLD). Methods: Patients with VHLD were screened using ophthalmoscopy and widefield OCTA. Detected RHs were classified with regard to tumor morphology (endophytic, sessile, exophytic, recurrent) and size. Then, 6 × 6- or 3 × 3-mm2 en face OCTA scans of the RHs were uploaded to the Navilas system, generating a merged image combining the scan and Navilas fundus photography. LP was planned by placing laser spots in the OCTA scan and executed with the Navilas system. Treatment efficacy was assessed by conducting OCTA scans immediately after LP and at follow-up visits. Results: Fifteen RHs were detected in 10 patients (median, one RH; range, one to four). Twelve RHs were treatment naive (exophytic [3], sessile [3], and endophytic [6]), and there were three recurrent RHs in pretreated areas. Total applied energy per tumor correlated with tumor size (P < 0.001). After a mean first follow-up of 3.6 ± 1.5 months (range, 0.9-5.3), nine RHs exhibited complete regression (60%), five partial regression (33.3%), and one no regression (6.7%). No correlation between tumor morphology and treatment success was observed (P = 0.32). However, a correlation between treatment success and tumor size trended toward significance (P = 0.08), with a 100% success rate observed for small RHs. Conclusions: OCTA-guided LP via the Navilas Laser System is a promising technique, especially beneficial for targeting small RHs. Combining OCTA and ophthalmoscopy improves tumor detection, underscoring the utility of this approach. Translational Relevance: OCTA-guided LP enables highly precise and safe treatment of early-stage RHs, minimizing possible complications caused by LP or the tumor itself.
Databáze:	MEDLINE
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