Transretinal biopsy via 23-gauge pars plana vitrectomy for retinal and choroidal tumors: cytopathological results, surgical complications, and patient outcomes

Gündüz, Ahmet Kaan; Mirzayev, Ibadulla; Ceyhan, Koray; Ateş, Funda Seher Özalp

doi:10.1007/s10384-020-00795-4

Cited by 2 publications

(3 citation statements)

References 25 publications

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“…22,23,24,25,26,27,28,29 Choroidal melanoma was detected in 50-100% of cases in cyto/histopathological examination of TRB material. 22,23,24,25,26,27,28,30,31,32 Therefore, TRB is mostly performed for the diagnosis of uveal melanoma. Other diagnoses include metastasis, lymphoma, retinal vasoproliferative tumor (RVT), choroidal hemangioma, choroidal plasmacytoma, choroidal neovascularization, and subretinal hemorrhage.…”

Section: Transretinal Biopsy With Pars Plana Vitrectomymentioning

confidence: 99%

“…TRB-related complications reported in 354 cases included vitreous hemorrhage (n=151, 42.7%), retinal detachment (n=11, 3.1%), transient intraocular pressure increase (n=6, 1.7%), glaucoma (n=1, 0.3%), hyphema (n=1, 0.3%), macular hole (n=1, 0.3%), choroidal neovascularization (n=1, 0.3%), and phthisis bulbi (n=1, 0.3%). 22,24,26,27,28,30,31,32,33 Complications reported in previous studies on TRB are summarized in Table 2.…”

Section: Transretinal Biopsy With Pars Plana Vitrectomymentioning

confidence: 99%

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Surgical Approach in Intraocular Tumors

Gündüz¹,

Mirzayev²

2022

tjo

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Surgery in intraocular tumors is done for excision/biopsy and the management of complications secondary to the treatment of these tumors. Excision/biopsy of intraocular tumors can be done via fine-needle aspiration biopsy (FNAB), transretinal biopsy (TRB), partial lamellar sclerouvectomy (PLSU), and endoresection. FNAB, TRB, and PLSU can be used in tumors that cannot be diagnosed by clinical examination and other ancillary testing methods. PLSU is employed in tumors involving the iridociliary region and choroid anterior to the equator. Excisional PLSU is performed for iridociliary and ciliary body tumors with less than 3 clock hours of iris and ciliary body involvement and choroidal tumors with a base diameter less than 15 mm. However, for biopsy, PLSU can be employed with any size tumor. Endoresection is a procedure whereby the intraocular tumor is excised using vitrectomy techniques. The rationale for performing endoresection is based on the fact that irradiated uveal melanomas may cause complications such as exudation, neovascular glaucoma, and intraocular pigment and tumor dissemination (toxic tumor syndrome), and removing the dead tumor tissue may contribute to better visual outcome. Endoresection is recommended 1-2 weeks after external radiotherapy. Pars plana vitrectomy is also used in the management of complications including vitreous hemorrhage, retinal detachment, and epiretinal membrane that can occur after treatment of posterior segment tumors using radiotherapy and transpupillary thermotherapy. It is important to make sure the intraocular tumor has been eradicated before embarking on such treatment.

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Section: Transretinal Biopsy With Pars Plana Vitrectomymentioning

confidence: 99%

Section: Transretinal Biopsy With Pars Plana Vitrectomymentioning

confidence: 99%

Surgical Approach in Intraocular Tumors

Gündüz¹,

Mirzayev²

2022

tjo

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“…We reviewed the abstracts and full texts of the identified articles and the related references. Simultaneous occurrence of choroidal melanoma and MH was reported in 10 patients in eight publications ( 6 – 13 ), after excluding one case with MH in which it was difficult to determine the intraocular tumor type ( 14 ) and one case in which MH was considered a post-vitrectomy complication ( 15 ). The findings of the literature review and the current case are presented in Table 1 .…”

Section: Review Of the Literaturementioning

confidence: 99%

Macular hole and vitreous hemorrhage subsequent to stereotactic hypofractionated radiotherapy for choroidal melanoma: A case report and review of the literature

2022

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Choroidal melanoma is the leading primary intraocular tumor with potentially fatal outcomes in adults. The coexistence of choroidal melanoma and a macular hole is extremely rare, and treatment strategies and information on the prognosis of associated complications are currently lacking. We report the first case of choroidal melanoma complicated with a macular hole and vitreous hemorrhage after stereotactic hypofractionated radiotherapy in Japan, and review the relevant literature in relation to the possible mechanisms, treatment strategies, and outcomes. An 83-year-old male with choroidal melanoma was treated with stereotactic hypofractionated radiotherapy in January 2021. Five months later, a full-thickness macular hole developed, followed by an acute massive vitreous hemorrhage about 2 weeks later. Following confirmation of tumor regression, the patient underwent a pars plana vitrectomy and internal limiting membrane peeling. The macular hole was closed postoperatively and the patient’s best-corrected visual acuity improved to 20/125. There was no evidence of intraocular tumor dissemination or distant metastases during follow-up. A systematic literature search only identified 10 previous cases of choroidal melanoma with a macular hole in eight reports worldwide, mainly in females. Macular edema may be the primary cause of macular hole formation in these cases. Most patients who underwent vitrectomy for complications after tumor regression achieved a good prognosis. The development of a macular hole is a rare complication associated with choroidal melanoma. Anterior-posterior traction of posterior vitreous detachment and secondary macular edema may have contributed to the formation of the macular hole in the current case.

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Transretinal biopsy via 23-gauge pars plana vitrectomy for retinal and choroidal tumors: cytopathological results, surgical complications, and patient outcomes

Cited by 2 publications

References 25 publications

Surgical Approach in Intraocular Tumors

Surgical Approach in Intraocular Tumors

Macular hole and vitreous hemorrhage subsequent to stereotactic hypofractionated radiotherapy for choroidal melanoma: A case report and review of the literature

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