A system of treatment options for retinal angiomatosis: from selective thermotherapy to endoresection

Purpos. To systematize approaches to laser and surgical treatment of retinal angiomatosis based on the disease stage; to identify optimal methods aimed to complete tumor regression. Material and methods. This study included 75 patients (107 eyes) with 268 retinal capillary hemangioblastomas of various localizations who received treatment at the St. Petersburg branch of the S. Fyodorov Eye Microsurgery Federal State Institution, from 2010 to 2024. An analysis was performed to evaluate the effectiveness of different treatment methods: laser photocoagulation, transpupillary thermotherapy, and vitreoretinal surgery — based on the stage of the disease and tumor size. Results. It was established that laser photocoagulation is effective only at Stage I of the disease when the tumor size does not exceed 1 mm. In contrast, transpupillary thermotherapy provides a high degree of regression of capillary hemangioblastomas at Stages I, II, and III. In cases of massive exudation and subtotal retinal detachment, endovitreal surgery with intraoperative thermotherapy and endoresection of the tumors is considered appropriate. Conclusion. A comprehensive approach to the treatment of retinal angiomatosis based on the disease stage, tumor size, and localization has been developed. The proposed system includes early diagnosis, timely and effective treatment, and active follow-up. This strategy helps to minimize complications and improve the prognosis for visual function preservation.