Case Rep Ophthalmol 2014;5:162–167 DOI: 10.1159/000363564 Published online: May 29, 2014 © 2014 S. Karger AG, Basel 1663‒2699/14/0052‒0162$39.50/0 www.karger.com/cop This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA- license), applicable to the online version of the article only. Distribution permitted for non- commercial purposes only. Andrea Saitta Ophthalmology, Department of Neuroscience Polytechnic University of Marche Via Conca 71, IT–60020 Ancona (Italy) E-Mail andrea@dottorsaitta.it 25-Gauge Vitrectomy Combined with Half-Fluence Photodynamic Therapy for the Treatment of Juxtapapillary Retinal Capillary Hemangioma: A Case Report Cesare Mariotti a Alfonso Giovannini a Michele Reibaldi b Michele Nicolai a Andrea Saitta a a Ophthalmology Department, Polytechnic University of Marche, Ancona, and b Department of Ophthalmology, University of Catania, Catania, Italy Key Words 25-Gauge vitrectomy · Juxtapapillary retinal capillary hemangioma · Photodynamic treatment · von Hippel-Lindau disease Abstract A rare case of juxtapapillary retinal capillary hemangioma (JRCH) with tractional macular detachment that was managed successfully with minimally invasive 25-gauge vitreoretinal surgery, followed by two sessions of half-fluence photodynamic treatment (PDT) with good visual outcome, is presented. A 13-year-old female patient had progressive deterioration of the vision of her right eye due to the presence of tractional macular detachment associated with JRCH in von Hippel-Lindau (VHL) disease. A 25-gauge sutureless vitreoretinal surgery was successfully performed. Two months following surgery, the JRCH was treated with two sessions of half-fluence PDT at an interval of 4 months. Visual acuity improved from a preoperative level of 20/50 to 20/25 24 months postoperatively. Resolution of the tractional macular detachment, reduction of papillomacular area fluid, and reduction in size of the JRCH were observed during the follow-up period. No serious adverse events were observed. Small-gauge vitreoretinal surgery followed by PDT can be effective and safe in relieving tractional macular detachment and recovering useful visual acuity in JRCH in VHL disease. © 2014 S. Karger AG, Basel