Retinal vasoproliferative tumors in ocular conditions of childhood

Shields, Jerry A.; Reichstein, David; Mashayekhi, Arman; Shields, Carol L.

doi:10.1016/j.jaapos.2011.10.010

Cited by 30 publications

(23 citation statements)

References 43 publications

(32 reference statements)

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“…5 Additionally, FA has an important role in the evaluation and management of pediatric vascular disorders including Coats’ disease, 6 choroidal neovascular membranes, 7 sickle cell retinopathy, 8 ocular tumors, 9 and other conditions. 10, 11 FA appears to be safe in children including neonates with ROP, with no adverse effects reported in several series.…”

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confidence: 99%

Influence of Fluorescein Angiography on the Diagnosis and Management of Retinopathy of Prematurity

et al. 2015

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Purpose To examine the influence of fluorescein angiography (FA) on the diagnosis and management of retinopathy of prematurity (ROP). Design Prospective cohort study. Participants Nine recognized ROP experts (3 pediatric ophthalmologists; 6 retina specialists) interpreted 32 sets (16 color fundus photographs; 16 color fundus photographs paired with the corresponding FAs) of wide-angle retinal images from infants with ROP. Methods All experts independently reviewed the 32 image sets on a secure web site and provided a diagnosis and management plan for the case presented, first based on color fundus photographs alone, and then by color fundus photographs and corresponding FA. Main Outcome Measures Sensitivity and specificity of the ROP diagnosis (zone, stage, plus disease, and category – i.e. no ROP, mild ROP, type-2 ROP, and treatment-requiring ROP) was calculated using a consensus reference standard diagnosis, determined from the diagnosis of the color fundus photographs by three experienced readers in combination with the clinical diagnosis based on ophthalmoscopic examination. The kappa statistic was used to analyze the average intergrader agreement among experts for the diagnosis of zone, stage, plus disease, and category. Results Addition of FA to color fundus photographs resulted in a significant improvement in sensitivity for diagnosis of stage 3 or worse disease (39.8% vs. 74.1%, P = 0.008), type-2 or worse ROP (69.4% vs. 86.8%, P = 0.013), and pre-plus or worse disease (50.5 vs. 62.6%, P = 0.031). There was a nonsignificant trend towards improved sensitivity for diagnosis of treatment-requiring ROP (22.2% vs. 40.3%, P = 0.063). Using the kappa statistic, addition of FA to color fundus photographs significantly improved intergrader agreement for diagnosis of treatment-requiring ROP. Addition of FA to color fundus photographs did not significantly affect intergrader agreement for the diagnosis of stage, zone, or plus disease. Conclusions Compared to color fundus photographs alone, fluorescein angiography may improve the sensitivity of diagnosis of ROP by experts, particularly for stage 3 disease. In addition, intergrader agreement for diagnosis of treatment-requiring ROP may improve with FA interpretation.

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confidence: 99%

Influence of Fluorescein Angiography on the Diagnosis and Management of Retinopathy of Prematurity

et al. 2015

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“…1,2,[4][5][6][30][31][32][33][34][35] Others have observed in single cases or small series that cryotherapy can resolve the tumor and also stimulate spontaneous peeling of remote ERM. 1,12-14 Gass 36 observed spontaneous peeling of ERM after cryotherapy and photocoagulation in a 23-year-old patient with retinal capillary hemangioma.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The majority of VPT are detected in the third and fourth decades of life, and this tumor manifests as a yellow-red retinal mass, with slightly dilated retinal feeding artery and vein, often producing subretinal fluid and exudation. [1][2][3][4][5] Based on an analysis of 334 cases of VPT by Shields et al, primary VPT presented, at a mean age of 46 years, as a solitary (95%) unilateral (94%) mass located anterior to the equator (77%). In contrast, secondary VPT presented earlier at mean age of 38 years, with bilateral (20%) and multifocal (15%) lesions.…”

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confidence: 99%

Cryotherapy-Induced Release of Epiretinal Membrane Associated With Retinal Vasoproliferative Tumor

Manjandavida

Shields²,

Kaliki³

et al. 2014

Retina

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“…2 Secondary VPTs are more often multifocal, bilateral, and believed to be a reactive vascular response to a variety of ocular insults. 4,[14][15][16][17][18][19][20][21][22][23][24][25] In our series of 67 eyes with secondary VPT, the underlying ocular conditions included retinitis pigmentosa (22%), pars planitis (21%), Coats disease (16%), previous retinal detachment repair (12%), and others (Table 4).…”

Section: Commentmentioning

confidence: 99%

“…2 In addition to these reports, several publications have further contributed to our understanding of this unusual tumor. [3][4][5][6][7][8][9][10][11][12][13][14] Vasoproliferative tumor is now classified into 2 types including primary (idiopathic) (74% of cases) or secondary (26%), based on related ophthalmic findings. 2 Both primary and secondary VPTs have been recognized to occur inferotemporally or inferiorly in the fundus and both can produce retinal exudation, detachment, and remote macular edema with visual acuity compromise.…”

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confidence: 99%