Management of Vision-Threatening Complications of Vasoproliferative Tumors of the Retina

Abstract

Aims: To report the management of vision-threatening complications of vasoproliferative tumors of the retina. Methods: Clinical records of 31 eyes of 30 patients treated at our centers from 1998 through 2013 were reviewed. The main outcome measures included: type of treatment, tumor regression, tumor relapse and final visual acuity. Results: Seventeen patients (57%) underwent vitrectomy for epimacular membranes (n = 10), rhegmatogenous retinal detachment (n = 2), vitreous hemorrhage (n = 2), tractional retinal detachment (n = 1), serous retinal detachment (n = 1) and subhyaloid hemorrhage (n = 1). After the initial treatment, 10 additional surgeries were performed for vitreoretinal complications. Tumor activity was treated in all eyes either with photocoagulation or cryotherapy. Control of tumor activity was achieved in all cases, after treatment of recurrences. There were no statistically significant differences between initial and final visual acuity (p = 0.437). Recurrence showed a statistically significant association with the presence of proliferative vitreoretinopathy (p = 0.024), tumor thickness (p = 0.026), basal diameter (p = 0.031), and use of photocoagulation alone as initial treatment (p = 0.006, logistic regression). Conclusion: In our series, more than half of vasoproliferative tumors of the retina required surgery as the initial treatment. Recurrence was associated with tumor size, presence of proliferative vitreoretinopathy, and use of photocoagulation alone as the initial treatment.

The Relationship Between Vasoproliferative Tumor and Uveitis in a Multiple Sclerosis Patient: A Case Report and Review of the Literature

“…Vitreoretinal surgery can be performed in patients with vitreous hemorrhage. 1,3,12,13,14,15 Of 160 patients with retinal detachment who underwent simultaneous cryotherapy and detachment surgery, 19 (12%) developed postoperative pigment shedding, while 7 (12%) of the 60 patients who did not undergo subretinal fluid drainage developed postoperative uveitis. 16 The same study reported that post-cryotherapy uveitis occurred in an average of 5-8 days.…”

Clinical characters and treatments of retinal vasoproliferative tumors

“…The most common anterior segment complication in eyes with VPT was glaucoma. 7 One patient had complicated neovascular glaucoma due to peripheral anterior synechia and neo-vascularization in the iris and angle. 9 After receiving VT and tumor resection, the intraocular pressure was normalized.…”

“… 2 3 4 5 6 Most patients suffer from visual symptoms that are secondary to leakage and inflammation of this peripheral vascular tumor, such as decreased vision, floater, distortion, or photopsia. 7 8 Without dilating the pupil and checking the peripheral retina, the VPT might be missed. Visual acuity (VA) varied from light perception to 6/6, depending on the complications of VPT.…”

“…Visual acuity (VA) varied from light perception to 6/6, depending on the complications of VPT. 7 8 The clinical course was generally insidious and slow but exudative retinal detachment with macula involvement or neovascular glaucoma has been reported. 8 9 …”

Klinik, Bildgebung und Therapie eines symptomatischen vasoproliferativen Tumors der Netzhaut (VPTR)

“…Sie sind jedoch meist nicht peripher, sondern zentraler lokalisiert. Die Behandlung vasoproliferativer Tumoren ist abhängig von der Größe der Läsion und dem Vorhandensein sekundärer Komplikationen [1,2,6]. Asymptomatische und kleine Tumoren, die überwiegend bei Routineuntersuchungen als Zufallsbefund diagnostiziert werden, zeigen oft nur eine geringere Progression und sollten daher zunächst beobachtet werden.…”