Retinal angiomas are vascular hamartomatous lesions that can have serious systemic and visual consequences. Early detection and treatment of retinal angiomas, together with a thorough systemic examination for related systemic disorders, can help to avert vision loss, morbidity, and death. Tumors having a diameter of less than 3 mm may generally be ablated with laser photocoagulation.
Cryotherapy should be used only in eyes when the laser cannot be used due to media opacities or when the tumor is in a superficial serous detachment or in the extreme peripheral retina. Pars plana vitrectomy coupled with photocoagulation or cryotherapy of the retinal angioma can effectively cure macular puckers or tractional macular detachments caused by retinal angiomas. Penetrating diathermy is an effective alternative therapy for big tumors, but it comes with the danger of bleeding and unintentional retinal fractures, which can result in vitreous loss or retinal detachment.
Proton-beam irradiation has been demonstrated to be an effective and safe therapy for big retinal angiomas (> 3 mm), as well as situations involving exudative retinal detachments or malignancies of the optic nerve. This novel, noninvasive approach, we feel, is a huge step forward in the treatment of complex retinal angiomas or tumors that have failed to react to other treatments.