Clinical characters and treatments of retinal vasoproliferative tumors

Huang, Yiming; Chen, Shih‐Jen

doi:10.1016/j.tjo.2016.04.003

Cited by 11 publications

(9 citation statements)

References 20 publications

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“…Preoperative anti-vascular endothelial growth factor and/or PDT could also be considered for the treatment of retinal vasoproliferative tumors and may reduce the risk of intra- or postoperative bleeding after tumor excision [ 17 ]. However, PDT is difficult to apply to a tumor in the far periphery, and these treatment modalities could potentially lead to an increase in fibrosis and retinal traction.…”

Section: Discussionmentioning

confidence: 99%

Surgery for Combined Hamartoma of the Retina and Retinal Pigment Epithelium

Sommen¹,

Romunde²,

Overdam³

2021

Case Rep Ophthalmol

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There is no consensus on whether and when surgical treatment is indicated for combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). We aim to discuss the benefits of surgical intervention and techniques that may improve the outcome. A 24-year-old man experienced progressive visual loss for 6 months in his left eye due to CHRRPE. At presentation, visual acuity was 1.3 LogMAR and fundoscopy revealed extensive tractional pre- and epiretinal membranes, subretinal exudation, and a vasoproliferative tumor in the inferior periphery. A complete vitrectomy was performed, while paying special attention to vitreous shaving at the vitreous base and removal of vitreoschisis-induced vitreous cortex remnants (VCR) from the retinal surface posterior to the vitreous base. Tractional membranes and internal limiting membrane were peeled, and the vasoproliferative tumor was excised. Silicone oil tamponade was removed 11 weeks after surgery. No intra- or postoperative complications occurred. Visual acuity improved to 0.8 LogMAR and remained stable for 48-month follow-up. Vitreoretinal surgery can prevent complications that occur with CHRRPE. In addition, visual function may improve even if the initial visual acuity is low. Timely and complete vitrectomy with extensive membranectomy and detection and removal of VCR is recommended to avoid complications in challenging CHRRPE.

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Section: Discussionmentioning

confidence: 99%

Surgery for Combined Hamartoma of the Retina and Retinal Pigment Epithelium

Sommen¹,

Romunde²,

Overdam³

2021

Case Rep Ophthalmol

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“…Ancillary testing including FFA may be helpful in confirming the diagnosis of VPT. FFA can be used to exclude other retinal vascular lesions by revealing early or late hyperfluorescence associated with leakage from the tumor, especially if the VPT is not covered with hemorrhages or extensive membranes that might block the full extent of the activity [ 11 , 13 ]. It also can be used to assess tumor activity after treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Rundle et al [ 15 ] reported a case with an association between Waardenburg syndrome and secondary VPT, a link that was attributed to the defective retinal pigment epithelium seen with the syndrome, which also was evident in our case. Multiple treatment modalities with variable results have been used to minimize or eliminate the consequences to visual function of VPT, including cryotherapy, laser photocoagulation, intravitreal anti–vascular endothelial growth factor, photodynamic therapy, and even vitreoretinal surgery, especially if the tumor is associated with vitreous bleeding or retinal detachment [ 8 , 13 ]. In our case, VPT was not affecting the patient’s visual acuity or macular area, so rather than risk a decrease in his vision, we did not use any of these modalities.…”

Section: Discussionmentioning

confidence: 99%

Retinal Vasoproliferative Tumor in Ocular Albinism

et al. 2020

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Patient: Male, 42-year-old Final Diagnosis: Ocular albinism Symptoms: Vision loss Medication: — Clinical Procedure: — Specialty: Ophthalmology Objective: Rare disease Background: Retinal vasoproliferative tumor (VPT) is a type of ocular vascular tumor that commonly occurs idiopathically and can be associated with secondary ocular diseases. Ocular albinism is an X-linked inherited disease and distinguished from oculocutaneous albinism by less hair and skin involvement. Case Report: A 42-year-old man with ocular albinism and moderate myopia presented with a history of insidious decrease in vision in both eyes over a period of months. On examination, the horizontal pendular nystagmus was present and diffuse iris transillumination defects were observed bilaterally. A fundus examination revealed a de-pigmented fundus with visible choroidal vessels, foveal hypoplasia, and a unilateral, elevated, vascular lesion in the superotemporal aspect of the retinal periphery. Optical coherence tomography of the lesion confirmed the retinal location and fluorescein fundus angiography indicated its vascular nature. B-scan ultrasonography was performed to measure the dimensions of the lesion. Conclusions: Rare retinal VPT has been reported with systemic and ocular associations, but it has never been reported in the literature in association with ocular albinism. Multiple treatment modalities have been described for the tumor, but observation can be considered in the absence of secondary consequences of the VPT. Retinal VPT should be included in the differential diagnosis of any retinal vascular abnormalities in patients with ocular albinism.

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“…The most common features reported are massive intraretinal and subretinal exudation, vitreous hemorrhage, exudative retinal detachment, epiretinal membrane and cystoid macular edema. 5,11,12 Observation is usually needed for small, peripheral tumors without any secondary complications, while most cases are associated with all the aforementioned vision threatening complications warranting appropriate treatment. Various treatment methods described till date include laser photocoagulation, transpupillary thermotherapy, cryotherapy alone or combined with encirclage or anti-vascular endothelial growth factor (VEGF), photodynamic therapy, endoresection, plaque brachytherapy and pars plana vitrectomy.…”

Section: Introductionmentioning

confidence: 99%

Vasoproliferative retinal tumors: Clinical presentation and treatment outcome

Kiri

Raval

Ali

et al. 2022

European Journal of Ophthalmology

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Objective To study the clinical presentation and treatment outcomes of patients with vasoproliferative retinal tumor (VPRT) in India. Methods Retrospective study of 50 eyes in 47 patients. Results Of the 50 eyes, 25 (50%) were primary and 25 (50%) were secondary. Common ocular pathologies related to secondary VPRT included retinal detachment (n = 8, 32%) and Coats disease (n = 7, 28%). Overall, the mean age at presentation was 35 years (range; 3–74 years) and included 30 (64%) males and 17 (36%) females. The lesions were unilateral in 44 (94%) patients. Secondary retinal features included intra/subretinal exudation (n = 41, 82%), vascularity (n = 32, 64%), subretinal fluid (n = 21, 42%), retinal neovascularisation (n = 9, 18%) and vitreous hemorrhage (n = 8, 16%). Thirty-four eyes (68%) underwent cryotherapy, of which 16 eyes (47%) received adjunct intravitreal anti-VEGF (12 eyes) or corticosteroid injection (4 eyes). Primary surgery included vitrectomy with/without encirclage and cryotherapy (n = 12, 24%) and plaque brachytherapy (n = 3, 6%). At last follow-up (mean 9.7 months, range 3–67 months), 42 eyes (84%) had complete tumor regression with no improvement in visual outcomes when comparing presenting and final best corrected visual acuity. Comparing primary versus secondary VPRT, secondary VPRT presented a decade earlier (31 vs 40 years), needed surgical intervention (48% vs 20%), had poor tumor control (72% vs 92%) and worse visual outcomes ( p < 0.05). Conclusion VPRTs commonly present as a unilateral lesions in the adult population with equal prevalence of primary and secondary variants. Compared with primary VPRT, secondary VPRTs require surgical treatment and are associated with poor visual outcome.

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Clinical characters and treatments of retinal vasoproliferative tumors

Cited by 11 publications

References 20 publications

Surgery for Combined Hamartoma of the Retina and Retinal Pigment Epithelium

Surgery for Combined Hamartoma of the Retina and Retinal Pigment Epithelium

Retinal Vasoproliferative Tumor in Ocular Albinism

Vasoproliferative retinal tumors: Clinical presentation and treatment outcome

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