Spontaneous Regression of Parafoveal Exudates and Serous Retinal Detachment in a Patient With Tuberous Sclerosis and Retinal Astrocytomas

Panzo, Gregory J.; Meyers, Sanford M.; Gutman, Froncie A.; Kollarits, Carol R.; Lederman, Richard J.

doi:10.1097/00006982-198400440-00005

Cited by 15 publications

(9 citation statements)

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“…Spontaneous regression of subretinal fluid was reported in three cases within several weeks (Panzo et al. 1984; Sahli et al.…”

Section: Resultsmentioning

confidence: 99%

“…The vascularization of the tumour becomes evident on fluorescein angiography with numerous abnormal vessels on its surface (Harley & Grover 1970;Gass 1997). While most retinal astrocytic hamartomas remain asymptomatic or gradually regress during life (Zimmer-Galler & Robertson 1995;Kiratli & Bilgic 2002), some exceptional cases may develop subretinal exudation or even vitreous haemorrhage (Atkinson et al 1973;Kroll et al 1981;Coppeto et al 1982;Panzo et al 1984;Jost & Olk 1986;Bloom & Mahl 1991;Sahli et al 1997;Vrabec & Augsburger 2003).…”

Section: Introductionmentioning

confidence: 99%

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Current treatment modalities for exudative retinal hamartomas secondary to tuberous sclerosis: review of the literature

Mennel

Meyer

Peter

et al. 2006

Acta Ophthalmologica Scandinavica

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ABSTRACT.Background: Retinal hamartoma is a common finding in tuberous sclerosis, but the symptomatic changes of this lesion have rarely been described. This evidence-based review evaluated the incidence of symptomatic retinal hamartoma and compared possible treatment modalities. Methods:We carried out a review of the literature using MEDLINE. Older publications not listed in MEDLINE were obtained from the reference list of currently published papers. Results: Three observational case series with a follow-up of up to 34 years included 93 patients and reported progression from a flat to a more elevated lesion without visual symptoms in nine patients (9.7%). Additional symptomatic changes were described in 11 case reports published over a period of three decades. The symptomatic alterations were caused by an enlarged tumour with leakage, macular oedema, accumulating lipoid exudates, serous retinal detachment (n ¼ 8 ⁄ 11) and vitreous haemorrhage (n ¼ 4 ⁄ 11). Most symptomatic cases involved a retinal hamartoma type 1 (n ¼ 6 ⁄ 8). Spontaneous resolution of symptomatic exudative hamartomas occurred in three patients within 4 weeks, although a delayed resorption of subretinal fluid caused permanent visual impairment in one patient. Investigational reports described a slow resorption of subretinal fluid after argon laser photocoagulation (n ¼ 2), although recurrent laser applications induced choroidal neovascularization and destruction of the neurosensory retina (n ¼ 1). A vitrectomy was used to remove a vitreous haemorrhage in another reported patient. In one case, complete resorption of subretinal fluid and an increase in visual acuity was observed within 2 weeks after a single treatment with photodynamic therapy (PDT). No complications were noted during a follow-up of 4 years.Conclusions: Symptomatic changes are very rare in retinal hamartomas secondary to tuberous sclerosis. Spontaneous resolution of subretinal fluid may occur within 4 weeks. If a macular oedema with increasing lipoid exudates persists over a period of 6 weeks, treatment should be considered. Although previous reports demonstrated possible visual stabilization after argon laser photocoagulation, vision-threatening complications can occur. Current treatment strategies may include PDT based on favourable anatomical and functional results.

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“…Spontaneous regression of subretinal fluid was reported in three cases within several weeks (Panzo et al. 1984; Sahli et al.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current treatment modalities for exudative retinal hamartomas secondary to tuberous sclerosis: review of the literature

Mennel

Meyer

Peter

et al. 2006

Acta Ophthalmologica Scandinavica

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“…The review of the literature disclosed 19 publications of retinal hamartomas that were evaluated using AF or by FA or ICGA [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. We have listed these publications and defined which of the above-mentioned examinations have been performed (table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Late-phase FA allowed the differentiation. Type 3 lesions presented a homogenous hyperfluorescence of all parts of the lesions, including the rim [8, 10, 11, 15]. The first ICG examinations in retinal hamartomas due to tuberous sclerosis were published by Kropinska et al [14], describing a type 2 hamartoma with a typical mulberry-like appearance.…”

Section: Discussionmentioning

confidence: 99%

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Autofluorescence and Angiographic Findings of Retinal Astrocytic Hamartomas in Tuberous Sclerosis

et al. 2005

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Objective: To describe fundus autofluorescence (AF), fluorescein angiography (FA) and indocyanine green angiography (ICGA) in different types of retinal astrocytic hamartomas in tuberous sclerosis (Morbus Bourneville-Pringle). Methods: Two eyes with 8 lesions, i.e. type 1 (n = 7) and type 3 (n = 1), were examined. AF pictures were taken prior to injection, FA and ICGA images were obtained in the early and the late phase. To achieve additional cases, a systematic literature review with exten- sive Internet and library search was performed. Results: Strong AF was seen in type 2 and type 3 retinal astrocytic hamartomas, whereas type 1 lesions blocked the physiologic fundus AF. Fluorescence angiography of all types of lesions revealed hypofluorescence in early frames and hyperfluorescence originating from leakage in late frames. ICGA showed a subtle blockade in type 1, a total blockade in type 2 and in the central part and a partial blockade in the peripheral part in type 3 lesions. Conclusions: Retinal astrocytic hamartomas in tuberous sclerosis can be easily detected by angiography, especially type 1 lesions which are difficult to visualize by funduscopy. Early- and late-phase fluorescein angiography and ICGA are helpful to differentiate the three lesion types.

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Retinal Astrocytic Tumors

Lee¹,

Lee²,

Singh³

2019

Clinical Ophthalmic Oncology

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Spontaneous Regression of Parafoveal Exudates and Serous Retinal Detachment in a Patient With Tuberous Sclerosis and Retinal Astrocytomas

Cited by 15 publications

References 0 publications

Current treatment modalities for exudative retinal hamartomas secondary to tuberous sclerosis: review of the literature

Current treatment modalities for exudative retinal hamartomas secondary to tuberous sclerosis: review of the literature

Autofluorescence and Angiographic Findings of Retinal Astrocytic Hamartomas in Tuberous Sclerosis

Retinal Astrocytic Tumors

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