Retinal vasoproliferative tumor in intermediate uveitis: A case report

[Retinal vasoproliferative tumor (retinal reactive astrocytic tumor)]

Retinal vasoproliferative tumor, otherwise known as retinal reactive astrocytic tumor, is a rare entity presenting as a mass in the inferior peripheral retina, associated with vascular abnormalities, and usually accompanied by exudative manifestations that affect the visual prognosis. The precise etiology is unknown, but the predominantly astrocytic and reactive nature of these lesions now appears to be established. It is classified as primary or secondary, and numerous associated ocular conditions have been reported, including pigmentary retinopathy, pars planitis and Coats' disease. The main differential diagnosis is the retinal capillary hemangioblastoma in von Hippel-Lindau disease. There is currently no consensus on the ideal treatment, and numerous therapeutic modalities have been described in limited case series, with variable success rates. Nevertheless, treatment is essential when there is a visual risk and is based on a combined, thoughtful approach to the various therapeutic modalities available, depending on the individual characteristics of the tumor. Conservative treatments such as laser photocoagulation, cryotherapy and/or photodynamic therapy are generally preferred for small tumors, while more invasive treatments such as brachytherapy are proposed for large lesions or tumors for which the exudative activity cannot be controlled. Vitreoretinal surgery is frequently required for complications such as retinal detachment, epiretinal membranes or vitreous hemorrhage. Intravitreal anti-VEGF injections are an adjuvant treatment for the macular edema frequently associated with the disease.

Retinal Vasoproliferative Tumours in Uveitis

PURPOSE

To describe a cohort of patients with retinal vasoproliferative tumours (RVPT) seen in the uveitis clinic of a single tertiary eye care institute in India.

METHODS

Retrospective Chart Review.

RESULTS

In our study of 17 patients with 18 eyes affected by RVPTs, 94.1% showed unilateral involvement, one patient had bilateral RVPTs, and another had two RVPTs in the same eye. The mean age was 36.3 ± 15.1 years (range: 12-63 years), with a male majority (76.4%). The most common location was inferotemporal quadrant (44.4%). The most common associated uveitic condition was intermediate uveitis (50%). Patients were treated with oral corticosteroid (in 94.1%) and immunosuppressive (35.2%) in addition to transconjunctival cryotherapy (in 52.9%) or laser photocoagulation (in 41.1%). Regression of the RVPT was achieved in all cases except one. Visual acuity at time of detection of RVPT ranged from 6/6 to HM. No significant change was noted in the mean best corrected visual acuity pre and post treatment in the study group.

CONCLUSION

RVPTs, rare peripheral retinal lesions often associated with intermediate uveitis, require early diagnosis with targeted therapy to prevent vision loss and achieve favorable long-term outcomes with rare recurrences.

[Morphological features of vasoproliferative tumor of the retina]

Vasoproliferative retinal tumor (VPT) is a term proposed by ophthalmologists in relation to the totality of manifestations of an intraocular volumetric process with involvement of the inner lining of the eye, an integral part of which is the active growth of blood vessels. The available literature data on the morphology of this process are very contradictory and ambiguous. The article presents two clinical cases of vasoproliferative retinal tumor with own illustration of morphological studies.