Argon Laser Treatment of von Hippel-Lindau Retinal Angiomas: I. Clinical and Angiographic Findings

Twelve angiomas in two patients with von Hippel-Lindau disease were photocoagulated with the argon laser. At the levels of energy employed, this instrument was capable of occluding small and medium-sized feeder arterioles, but not vessels of large caliber. The laser also appeared capable of obliterating small angiomas (<0.8 disc diameters) following direct photocoagulation of the angiomas themselves. Larger angiomas were not always as susceptible to argon treatment. Late recurrence was noted clinically in one patient. Direct coagulation of the angioma may preserve more visual field than interruption of feeder arterioles. Fluorescein angiography is often valuable in determining whether or not retreatment is indicated, but may occasionally indicate absence of perfusion in the presence of a viable tumor.