Trans‐vitreal endoresection for vasoproliferative retinal tumours

Abstract

We present an interventional consecutive case series to describe our experience of transvitreal endoresection (TVE) for vasoproliferative retinal tumours (VPRTs). Three patients with VPRTs refractory to conventional treatment modalities of cryotherapy, plaque radiotherapy and anti-VEGF presented with macular exudative changes and were offered TVE. Complete ophthalmic examination with colour fundal photographs was performed before and during the follow-up period. All patients were followed up for 6 months following silicone oil removal. At the last follow up, resolution of macular and retinal exudative changes with parallel improvement in vision was observed. No recurrences were detected during the follow-up period. Two of three patients had simultaneous cataract surgery and developed fibrinous uveitis, requiring management with intensive topical steroids. After 3 months, these patients had a fibrotic pupillary membrane enveloping the intraocular lens (IOL) with posterior synechiae. These two patients underwent SO removal, IOL explantation and artisan IOL (iris clipped) insertion, resulting in visual improvement. We did not observe any PVR complications in our cases. TVE represents an effective and safe option for the treatment of VPRTs refractory to other treatment modalities. Further studies with a larger sample size and long-term follow up are indicated to evaluate the role of TVE in the management of VPRTs.

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

“…Several treatments have been reported for VPTs, including photocoagulation [3] , cryotherapy [1,4,5] , brachytherapy [6][7][8] , transpupillary thermotherapy [7] , photodynamic therapy [9] , endoresection [10] , and vitreoretinal surgery for associated complications [11] . In this study we report our surgical experience with 39 VPTs in 30 patients.…”

Retinal vasoproliferative tumors in ocular conditions of childhood

“…The details of treatment methods for RVPTs have been published and is beyond the scope of this study. 9,11,[13][14][15]18,24,26,27,29,36,40 In conclusion, a number of pediatric-related ocular conditions appear to predispose patients to the development of secondary RVPT. Ophthalmologists, particularly pediatric ophthalmologists and retinal specialists, should be aware of secondary RVPTs and their various ocular and nonocular associations.…”

Retinal vasoproliferative tumor

“…There are reports of surgical resection for RVPTs that failed to respond to cryotherapy in association to intravi treous injections of antiangiogenics or as a primary treatment in an eye harboring multiple RVPTs and vitreous hemorrhage (27,28) . The surgery can be performed through pars plana vitrectomy or by a transcleral route (15,27,28) . Cataract is a common complication after vi trectomy in phakic eyes, specially when silicone oil or gas is used to seal the retinotomies necessary to perform tumor's endoresection.…”