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Coussa RG, Mansoor M, Boldt HC, Binkley EM. Nonpigmented Adenoma of the Retinal Pigment Epithelium Mimicking a Retinal Vasoproliferative Tumor Managed With Endoresection. JOURNAL OF VITREORETINAL DISEASES 2024; 8:343-348. [PMID: 38770086 PMCID: PMC11102728 DOI: 10.1177/24741264241240332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Purpose: To present a case with signs suggestive of a retinal vasoproliferative tumor. Methods: A case report was evaluated and a surgical video presented. Results: A 61-year-old White man presented with an amelanotic retinal tumor associated with exudation, retinal edema, and overlying telangiectatic vessels, suggestive of a retinal vasoproliferative tumor. Standardized echography showed an irregular mass with medium-to-high internal reflectivity and internal calcification, which suggested chronicity. He was initially treated for an exudative retinal detachment (RD) in the context of a presumed vasoproliferative tumor but later developed combined exudative and rhegmatogenous RD, prompting surgical repair with tumor endoresection. Pathology showed nonpigmented adenoma of the retinal pigment epithelium (RPE). Conclusions: Nonpigmented adenoma of the RPE is a rare tumor, and its clinical similarity to a vasoproliferative tumor should be noted. Endoresection may be considered in cases resulting in RD.
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Affiliation(s)
- Razek G. Coussa
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
- Dean McGee Eye Institute, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - Mahsaw Mansoor
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
| | - H. Culver Boldt
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
- Institute for Vision Research, University of Iowa, Iowa City, IA, USA
| | - Elaine M. Binkley
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
- Institute for Vision Research, University of Iowa, Iowa City, IA, USA
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Banerjee M, Sravani YSN, Azad SV, Venkatesh P. Evolution of retinal vasoproliferative tumour: clinical chronology using ultrawidefield imaging (UWFI). BMJ Case Rep 2024; 17:e258178. [PMID: 38417942 PMCID: PMC10900529 DOI: 10.1136/bcr-2023-258178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Affiliation(s)
- Mousumi Banerjee
- Dr. R. P. Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shorya Vardhan Azad
- Dr. R. P. Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep Venkatesh
- Dr. R. P. Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Hashimoto I, Takase H, Kase S, Iwasaki Y, Kobayashi D, Ohno-Matsui K. CLINICOPATHOLOGICAL ANALYSIS OF SECONDARY RETINAL VASOPROLIFERATIVE TUMOR/REACTIVE RETINAL ASTROCYTIC TUMOR SUCCESSFULLY TREATED BY ENDORESECTION. Retin Cases Brief Rep 2024; 18:106-111. [PMID: 36067444 DOI: 10.1097/icb.0000000000001310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To report the clinicopathological findings of retinal vasoproliferative tumor/reactive retinal astrocytic tumor (VPT/RRAT) with retinal vasculitis, treated by tumor resection. METHODS A retrospective single case report. PATIENT A 29-year-old Japanese woman was referred with cystoid macular edema and retinal vasculitis in the right eye. Best-corrected visual acuity was 0.9. Results of fundus examination, optical coherence tomography, and fluorescein angiography demonstrated VPT/RRATs in the temporal retina surrounded by a subretinal exudate, serous retinal detachment and macular edema, and retinal vasculitis. Despite 3 months of oral prednisolone treatment, a full-thickness macular hole developed. Pars plana vitrectomy and endoresection of the VPT/RRATs were performed. Pathologic and immunohistochemical analyses with anti-CD34 antibody, antiglial fibrillary acidic protein antibody, anti-Ki67 antibody, and anti-vascular endothelial growth factor antibody were performed on the excised tissue. Inflammation was evaluated by immunohistological staining with leukocyte common antigen (LCA), anti-CD3 antibody, and anti-CD20 antibody. RESULTS After surgery, the macular hole closed, best-corrected visual acuity improved to 1.2, retinal vasculitis was ameliorated, and retinal exudate disappeared. There was no recurrence of VPT/RRAT or retinal vasculitis. Pathologic examination showed that antiglial fibrillary acidic protein and anti-vascular endothelial growth factor were widely expressed, irrespective of the distribution of blood vessels. Ki67-positive proliferating cells were detected in the perivascular area. Leukocyte common antigen-positive leukocytes and CD3-positive T cells were detected throughout the samples, whereas CD20-positive B cells were rarely detected. CONCLUSION Endoresection of VPT/RRAT could be a good treatment option for secondary VPT/RRAT accompanied by retinal vasculitis. Pathologic findings revealed for the first time that inflammatory cells infiltrate the tissue in secondary VPT/RRAT.
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Affiliation(s)
- Izumi Hashimoto
- Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Ophthalmology, Nissan Tamagawa Hospital, Tokyo, Japan
| | - Hiroshi Takase
- Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoru Kase
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; and
| | - Yuko Iwasaki
- Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Kobayashi
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Jong JLZ, Jawaheer L, Spiteri-Cornish K, Chawla A. SURGICAL OUTCOMES OF PARS PLANA VITRECTOMY FOR INTRAOCULAR COMPLICATIONS RELATED TO VASOPROLIFERATIVE TUMOR OF THE RETINA. Retina 2023; 43:1980-1987. [PMID: 37418640 DOI: 10.1097/iae.0000000000003886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
PURPOSE To investigate the safety and efficacy of vitrectomy pars plana vitrectomy in managing intraocular complications relating to vasoproliferative tumors of the retina (VPL). METHODS Retrospective study. 17 patients with VPL who underwent vitrectomy at Sheffield Teaching Hospital NHS Trust from 2005 to 2020 were included. Patient demographics, clinical characteristics, intraoperative data, and surgical outcomes were collected and evaluated. RESULTS The mean age was 52 years. Indications for pars plana vitrectomy included epiretinal membrane (n = 7), vitreous hemorrhage (n = 5), retinal detachment (n = 3), diagnostic (n = 1), and others (n = 1). After pars plana vitrectomy, 14/17 (82.4%) have stabilized vision and 3/17 (17.6%) deteriorated. Subgroup analysis of epiretinal membrane peel had good outcomes with 6/7 (85.7%) noticing improvement or stabilization of symptoms and mean logarithm of minimal angle of resolution visual acuity improved from 0.719 [6/30] ± 0.267 [6/12] to 0.476 [6/19] ± 0.271 [6/12]. Patients undergoing surgery for vitreous hemorrhage also had good outcomes with resolution (and no recurrence) of the hemorrhage in 3/5 (60%) and 5/5 (100%) with one or more surgeries, respectively. Outcomes for retinal detachment surgery were logarithm of minimal angle of resolution 2.126 [HM] ± 0.301 [6/12] preoperatively and 1.185 [6/95] ± 0.522 [6/19] postoperatively, with one recurrence of retinal detachment. In the epiretinal membrane group, three patients had adjunctive treatment for VPL intraoperatively and four patients had none, and no difference found between the two groups in outcome or complications. Tumor with thickness of ≥2 mm exhibited inferior visual outcomes compared with <2 mm ( P < 0.05). CONCLUSION This is one of the largest data sets in looking at outcomes of vitrectomy for complications of VPL. Pars plana vitrectomy is effective and safe in managing VPL-related intraocular complications with good outcomes and a low rate of complications, especially for patients with epiretinal membrane and vitreous hemorrhage.
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Affiliation(s)
- Joel Lee Zher Jong
- Medical School, Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Trust, Sheffield, United Kingdom; and
| | - Lona Jawaheer
- Bristol Eye Hospital, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Kurt Spiteri-Cornish
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Trust, Sheffield, United Kingdom; and
| | - Anand Chawla
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Trust, Sheffield, United Kingdom; and
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Adeghate JO, Goldburg SR, Marr B, Sheyman A, Winokur J, Kaden TR. Repair of a Tractional Retinal Detachment in the Setting of an Idiopathic Vasoproliferative Tumor. Ophthalmic Surg Lasers Imaging Retina 2023; 54:485-488. [PMID: 37535613 DOI: 10.3928/23258160-20230726-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Vasoproliferative tumors (VPT) are benign retinal lesions that may cause epiretinal membrane proliferation and tractional retinal detachments (TRD). We describe a case of a 71-year-old woman who presented with a macula involving TRD in the setting of a VPT. Given the limited number of publications on the management of these cases, we aim to articulate some principles we believe may be helpful in planning a surgical approach that maximizes postoperative anatomic and functional outcomes. We hope that our video provides useful guidance in preparing the vitreoretinal surgeon for managing this uncommon entity. [Ophthalmic Surg Lasers Imaging Retina 2023;54:485-488.].
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Alahmadi R, AlZahem TA, Semidey VA. Epiretinal Membrane and Vitreomacular Traction Associated With Vasoproliferative Tumor in Macular Telangiectasia Type 2: A Case Report. Cureus 2023; 15:e34612. [PMID: 36891027 PMCID: PMC9986504 DOI: 10.7759/cureus.34612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/06/2023] Open
Abstract
We report a case of a 62-year-old man who presented with blurred and distorted vision in both eyes. Fundus examination revealed a fibrous band-like membrane emanating from the disc to the foveal center in the right eye, aneurysmal gray parafoveal lesions in both eyes, and an inferotemporal peripheral vascular tumor in the right eye. The presence of an epiretinal membrane with vitreomacular traction in this patient has led to the diagnosis of an incidental peripheral vascular tumor. To our knowledge, there are no reports describing an association between macular telangiectasia type 2 and epiretinal membrane formation with vitreomacular traction due to a vasoproliferative tumor.
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Affiliation(s)
- Reem Alahmadi
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Tariq A AlZahem
- Ophthalmology Department, College of Medicine, King Saud University Medical City, Riyadh, SAU
| | - Valmore A Semidey
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, SAU
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Case MJ, Lentz C, Duffy EW, Magrath GN, Cooper SL. Large Vasoproliferative Retinal Tumor Refractory to Cryotherapy Treated with Salvage I-125 Plaque Radiotherapy. Adv Radiat Oncol 2022; 7:100972. [PMID: 35665307 PMCID: PMC9160674 DOI: 10.1016/j.adro.2022.100972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/12/2022] [Indexed: 10/28/2022] Open
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Rishi P, Sreenivasan J. A case of primary vasoproliferative tumor with full-thickness macular hole. GMS OPHTHALMOLOGY CASES 2022; 12:Doc02. [PMID: 35291588 PMCID: PMC8900157 DOI: 10.3205/oc000189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
A 53-year-old female presented with defective vision in the left eye of one week duration with a best-corrected visual acuity (BCVA) of 6/9. Fundus examination showed a primary retinal vasoproliferative tumor (RVPT) at the inferotemporal quadrant and a small full-thickness macular hole (MH). The patient underwent cryotherapy for RVPT, followed later by vitrectomy with internal limiting membrane peeling and gas tamponade. The tumor regressed and the MH was closed with BCVA of 6/9. RVPT can present with remote macular complications like epiretinal membrane, cystoid macular edema, macular exudates, and rarely full-thickness MH. Management should be directed towards the tumor as well as the complication.
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Affiliation(s)
- Pukhraj Rishi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India,*To whom correspondence should be addressed: Pukhraj Rishi, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18, College Road, 600006 Chennai, Tamil Nadu, India, Phone: +91 44 28271616, Fax: +91 44 28254180, E-mail:
| | - Janani Sreenivasan
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Forgáč F, Sekerešová M, Černák M. EN BLOC RESECTION OF RETINAL VASOPROLIFERATIVE TUMOR USING 23G VITRECTOMY. A CASE REPORT. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2022; 78:206-213. [PMID: 35922148 DOI: 10.31348/2022/22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Retinal vasoproliferative tumor is one of the benign vascular tumors which in advanced stages leads to exudative retinal detachment with the formation of epiretinal and subretinal membranes. In such advanced stages, one of the therapeutic options is pars plana vitrectomy. This article presents the case of a patient on whom was performed 23-gauge pars plana phacovitrectomy with en bloc resection of the tumor followed by histological confirmation. CASE REPORT A 70-year-old patient with a one-year history of unilateral loss of vision in his left eye was admitted to our clinic for examination in February 2018. At admission, the best corrected visual acuity in the right eye was 1.0, and in the left eye was light perception. Based on the clinical picture, sonographic examination of the eye, and fluorescein angiography, the patient was diagnosed with a retinal vasoproliferative tumor. Due to the advanced stage of disease, we proceeded with surgical intervention. We performed 23-gauge phacovitrectomy with a bloc resection of the tumor. Subsequent histological examination confirmed the presence of the presumed tumor. The follow-up exam a few months later showed a completely attached retina with silicone oil tamponade, without exudative retinopathy. However, the best corrected visual acuity improved only slightly to the ability to count fingers at one meter. CONCLUSION Pars plana vitrectomy with en bloc resection of retinal vasoproliferative tumor is one of the therapeutic modalities in advanced stages.
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Zaguia F, Marchese A, Cicinelli MV, Miller VJ, Miserocchi E, Goldstein DA. Long-term success treating inflammatory epiretinal neovascularization with immunomodulatory therapy. Graefes Arch Clin Exp Ophthalmol 2021; 260:553-559. [PMID: 34499246 DOI: 10.1007/s00417-021-05396-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/11/2021] [Accepted: 08/22/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This study aims to report the long-term outcomes of uveitis-associated optic disc and epiretinal neovascularization (NV) treated with immunomodulatory therapy alone. METHODS This is a retrospective, multi-center chart review conducted at Northwestern University (Chicago, IL) and San Raffaele Scientific Institute (Milan, Italy) from 2014 to 2021 of patients with optic disc and/or retinal neovascularization associated with uveitis. The data collected included age at the time of NV detection, gender, medications, and follow-up period. Imaging was reviewed if available. RESULTS Eight eyes of six patients were identified. The mean age was 22 years (range 10-52 years); the median follow-up was 3 years (range 6 months to 7 years). All eyes presented with active NV at the time of uveitis onset; 7 eyes were treatment-naïve. None had clinical or angiographic evidence of retinal ischemia. All patients received a variable combination of local steroids, systemic steroids, and systemic immunosuppression. Complete resolution of uveitic NV occurred in all eyes within a median of 8 weeks (ranging 2-20 weeks) from initiating treatment. No NV recurrence was noted. CONCLUSION Immunomodulatory therapy alone may be successful in achieving long-term control of uveitis-associated NV, without the use of destructive measures.
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Affiliation(s)
- Fatma Zaguia
- Department of Ophthalmology, Uveitis Service, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Ste 440, Chicago, IL, 60611, USA
| | - Alessandro Marchese
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Victoria J Miller
- Department of Ophthalmology, Uveitis Service, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Ste 440, Chicago, IL, 60611, USA
| | | | - Debra A Goldstein
- Department of Ophthalmology, Uveitis Service, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Ste 440, Chicago, IL, 60611, USA.
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Diafas A, Toumanidou V, Kassos I, Samouilidou M, Dastiridou A, Ziakas N, Androudi S. Macular sequelae in vasoproliferative tumors: results of surgical approach. Int Ophthalmol 2021; 41:3515-3522. [PMID: 34173151 DOI: 10.1007/s10792-021-01918-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study is to report the clinical manifestations and treatment outcomes in three patients diagnosed with vasoproliferative tumors (VPTs). METHODS A retrospective, single-center case series was conducted, and retinal findings from three cases were documented by clinical examination and multimodal imaging. RESULTS Three patients presented with an elevated, yellow-white retinal lesion located at the peripheral retina and extensive retinal exudation. All three patients were closely monitored, and tumor-associated features included lipid exudates, cystoid macular edema (CMO), pre-retinal fibrosis and epi-retinal membrane (ERM). Clinical management relied on observation, cryotherapy, laser photocoagulation, intravitreal steroids and anti-vascular endothelial growth factor (anti-VEGF) treatment. Despite different clinical courses, two patients underwent vitreo-retinal surgery to address VPT-related complications of macular hole and vitreo-macular traction, whereas a patient underwent phacoemulsification to treat steroid-induced cataract. CONCLUSION VPTs are uncommon benign vascular tumors and usually located at the infero-temporal peripheral retina. Close observation and early diagnosis of VPTs are of great importance in preventing vision-threatening complications and ensuring the best final visual outcome. The optimal treatment has yet to be defined due to lack of multi-center clinical studies. Despite the availability of less invasive therapeutic interventions, however, our case series show that pars plana vitrectomy is sometimes the most appropriate choice to restore visual acuity.
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Affiliation(s)
- Asterios Diafas
- Department of Ophthalmology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | | | - Ioannis Kassos
- Department of Ophthalmology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Maria Samouilidou
- Department of Ophthalmology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Anna Dastiridou
- Department of Ophthalmology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Nikolaos Ziakas
- Department of Ophthalmology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Sofia Androudi
- Department of Ophthalmology, University of Thessaly, Larissa, Greece.
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Management of Vasoproliferative Tumors of the Retina with Macular Complications by Pars Plana Vitrectomy Combined with Episcleral Cryotherapy. J Ophthalmol 2021; 2021:6667755. [PMID: 33953967 PMCID: PMC8057872 DOI: 10.1155/2021/6667755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/08/2021] [Accepted: 03/26/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To evaluate the efficacy of pars plana vitrectomy (PPV) combined with episcleral cryotherapy in treating vasoproliferative tumors of the retina (VPTR) with macular complications. Methods In this retrospective noncomparative interventional case-series analysis, we included 11 eyes of ten patients diagnosed with VPTR. All patients underwent comprehensive ophthalmic examinations and were treated with PPV combined with episcleral cryotherapy. Best-corrected visual acuity (BCVA), tumor activity, retinal morphological structure, and postoperative complications were evaluated. Results Macular complications included epimacular membrane (n = 10), macular hole (n = 3), and macular edema (n = 1). Tumors were treated with triple freeze-thaw episcleral cryotherapy during PPV. The mean logarithm of minimal angle of resolution (logMAR) BCVA dropped from 0.62 ± 0.58 to 0.39 ± 0.46. The difference between the mean values of logMAR BCVA before and after treatment was statistically significant (t = 2.48, P=0.033). The tumor activity was controlled effectively in nine cases. Compared with preoperative tumor activity, tumor activity after treatment was significantly lower (P < 0.01). The increase of central retinal thickness and the disruption of retinal layers were associated with macular holes, macular edema, and retinal proliferative membrane. After the treatment, visual acuity improved in 91% of the cases, and 73% had no long-term complications. Conclusion PPV combined with episcleral cryotherapy promoted tumor regression, preserved retinal integrity, and improved visual acuity. Thus, the combination of PPV with episcleral cryotherapy can be considered effective and safe for the management of VPTR with macular complications.
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Matsuura S, Ishida T, Tobe M, Uchida M, Souma R, Ohno-Matsui K. Indocyanine green angiographic findings in seven eyes with vasoproliferative retinal tumor. Am J Ophthalmol Case Rep 2020; 19:100831. [PMID: 32715159 PMCID: PMC7374191 DOI: 10.1016/j.ajoc.2020.100831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose Vasoproliferative tumors (VPTs) are rare benign tumors, and detailed indocyanine green angiographic (ICGA) findings in eyes with VPTs have not been reported. We present the characteristic ICGA findings in seven eyes with a VPT. Observations We present the fluorescein angiographic (FA) and ICGA findings of seven consecutive patients who were diagnosed with primary VPT from April 2013 to March 2015 in the Oncology Service of the Department of Ophthalmology, Tokyo Medical and Dental University. We reviewed the demographics of the seven patients with VPTs. Abnormal vessels within the tumor were observed in three cases with active tumors. These vessels were hypofluorescent in the ICGA images in the scar phase. On the other hand, three cases in which the exudation remained from the initial visit to the last examination had abnormal vessels in the ICGA images. The remaining case had one straight vessel in the tumor from the initial to the last examination in the scar phase. FA in the active phase changed from hyperfluorescent leakage to staining in one eye, and the remaining six eyes continued to show hyperfluorescent leakage throughout the examination period. Conclusions The leakage of fluorescein continued from the initial to the final examination even after the activity of the tumor had decreased. In the active phase, ICGA showed abnormal vessels with or without leakage, and the tumors at the scar phase show a hypofluorescent lesion. Importance ICGA supported the ophthalmoscopic findings, and can be used as a diagnostic aid to confirm a regression of the VPTs.
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Affiliation(s)
- Saya Matsuura
- Department of Ophthalmology, Ebara Hospital, Tokyo, Japan
- Department of Ophthalmology, Tokyo Medical Dental University, Tokyo, Japan
- Corresponding author. Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University; 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Tomoka Ishida
- Department of Ophthalmology, Tokyo Medical Dental University, Tokyo, Japan
| | - Miho Tobe
- Department of Ophthalmology, Tokyo Medical Dental University, Tokyo, Japan
| | - Minami Uchida
- Department of Ophthalmology, Tokyo Medical Dental University, Tokyo, Japan
| | - Ryoko Souma
- Department of Ophthalmology, Tokyo Medical Dental University, Tokyo, Japan
- Department of Ophthalmology, National Disaster Medical Center, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology, Tokyo Medical Dental University, Tokyo, Japan
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Badawi AH, Semidey VA, Magliyah M, Al-Dhibi H. Updated Systematic Review and Clinical Spectrum of Peripheral Exudative Hemorrhagic Chorioretinopathy. Middle East Afr J Ophthalmol 2020; 27:4-9. [PMID: 32549717 PMCID: PMC7276165 DOI: 10.4103/meajo.meajo_85_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/12/2020] [Accepted: 04/17/2020] [Indexed: 11/20/2022] Open
Abstract
Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a rare retinal vasculopathy that might cause subretinal and/or vitreous hemorrhages. Although the primary etiology is still unknown, choroidal neovascularization is mainly involved in the pathogenesis. The main risk factors are age and systemic hypertension. Ancillary testing such as fluorescein angiography, indocyanine green angiography and ultrasonography can be of great value for diagnosing this entity and distinguishing PEHCR from other lesions as choroidal melanoma and retinal vasoproliferative tumor. Various treatments have been reported including photocoagulation, cryotherapy, intravitreal injection of anti-vascular endothelial growth factor (Anti-VEGF) and surgical intervention as pars plana vitrectomy. This review handles an up-to-date perspective regarding PEHCR.
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Affiliation(s)
| | - Valmore A Semidey
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Moustafa Magliyah
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology, Prince Mohammed Medical City, AlJouf, Saudi Arabia
| | - Hassan Al-Dhibi
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Abolfathzadeh N, Naseripour M, Jaberi R, Azma Z, Alemzadeh SA, Arbab M, Sedaghat A. Ru-106 plaque radiotherapy for vasoproliferative tumors of retina: a 15-year single-center experience. Int Ophthalmol 2020; 40:2095-2102. [PMID: 32361860 DOI: 10.1007/s10792-020-01386-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE This study evaluates the outcomes of ruthenium-106 (Ru-106) plaque brachytherapy for vasoproliferative tumors (VPTs) of the ocular fundus in a single referral ocular oncology center. METHODS The clinical charts of all patients diagnosed with VPT who underwent plaque radiotherapy from 2002 to 2017 were reviewed. Clinical features, types of treatment, outcomes and complications were evaluated. RESULTS Of 46 patients with VPT diagnosis in our ocular oncology clinic, 25 (54.34%) cases were treated with Ru-106 plaque brachytherapy. Eleven patients (44%) were male, and the mean age at the time of diagnosis was 40.92 ± 13.11 years. The mean follow-up time was 47.56 ± 36.87 months. Inferotemporal quadrant was the most common site of the tumor (64.00%). The mean delivered apex and scleral dose was 101.56 ± 6.51 and 412.26 ± 113.66 Gray (Gy), respectively. Initial tumor length, width and thickness were 10.26 ± 3.42, 8.05 ± 2.83 and 4.27 ± 1.10 mm, respectively. The mean tumor thickness decreased to 2.60 ± 0.63 mm, postoperatively. Complete resolution of subretinal fluid around the tumor was achieved in 81.80% of cases. Visual acuity was more than 20/400 in 64% of patients before treatment and 60% of patients at last follow-up. CONCLUSION Our study showed that Ru-106 plaque radiotherapy is an effective and safe method of treatment in VPTs.
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Affiliation(s)
- Navid Abolfathzadeh
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Sattarkhan-Niayesh Street, Tehran, 14456-13131, Iran.,Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masood Naseripour
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Sattarkhan-Niayesh Street, Tehran, 14456-13131, Iran
| | - Ramin Jaberi
- Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Azma
- Radiation Medicine Department, Shahid Beheshti University, Tehran, Iran
| | - Sayyed Amirpooya Alemzadeh
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Sattarkhan-Niayesh Street, Tehran, 14456-13131, Iran
| | - Mona Arbab
- Radiation Oncology Department, Indiana University, Indiana, USA
| | - Ahad Sedaghat
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Sattarkhan-Niayesh Street, Tehran, 14456-13131, Iran.
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Spontaneous avulsion of a retinal vasoproliferative tumour with resolution of epiretinal membrane. Can J Ophthalmol 2019; 54:e173-e174. [DOI: 10.1016/j.jcjo.2018.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 10/22/2018] [Indexed: 11/21/2022]
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Temblador-Barba I, Delgado-Alonso EM, Toribio-García M, Martínez-Campillo L, Molina-Leyva I, Martínez-Jiménez M. Update on the management of vasoproliferative tumour. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2018; 93:350-353. [PMID: 29459169 DOI: 10.1016/j.oftal.2018.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 06/08/2023]
Abstract
CASE REPORT Here we report a 19-year-old female patient who presented a vasoproliferative tumour. It caused complications, such as epiretinal membrane, macular oedema, vitreous haemorrhage, and exudative retinal detachment. The patient was treated with 3 injections of intravitreal bevacizumab, an intravitreal dexamethasone implant, tocilizumab, and double freeze-thaw cryotherapy. DISCUSSION Therapeutic options are: observation, if it is small, if it is a peripheral lesion, and if there seems to be no threat to vision. If it requires treatment, laser photocoagulation, intravitreal bevacizumab, trans-conjunctival cryotherapy, transpupillary thermotherapy, photodynamic therapy, brachytherapy plaques and surgery are the different options available. Recently, tocilizumab and intravitreal dexamethasone implants have been reported to be beneficial.
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Affiliation(s)
- I Temblador-Barba
- Servicio de Oftalmología, Hospital Universitario Virgen de las Nieves, Complejo Hospitalario Universitario, Granada, España.
| | - E M Delgado-Alonso
- Servicio de Oftalmología, Hospital Universitario Virgen de las Nieves, Complejo Hospitalario Universitario, Granada, España
| | - M Toribio-García
- Servicio de Oftalmología, Hospital Universitario Virgen de las Nieves, Complejo Hospitalario Universitario, Granada, España
| | - L Martínez-Campillo
- Servicio de Oftalmología, Hospital Universitario Virgen de las Nieves, Complejo Hospitalario Universitario, Granada, España
| | - I Molina-Leyva
- Servicio de Oftalmología, Hospital Universitario Virgen de las Nieves, Complejo Hospitalario Universitario, Granada, España
| | - M Martínez-Jiménez
- Servicio de Oftalmología, Hospital Universitario Virgen de las Nieves, Complejo Hospitalario Universitario, Granada, España
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Walinjkar JA, Sharma US, Rishi P, Rishi E, Gopal L, Sharma T. Clinical features and treatment outcomes of vasoproliferative tumors in Indian participants. Indian J Ophthalmol 2018; 66:246-251. [PMID: 29380768 PMCID: PMC5819105 DOI: 10.4103/ijo.ijo_210_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The aim of the study was to describe the clinical features and treatment outcomes of vasoproliferative tumors (VPT) in Indian participants. Methods: This study design was a retrospective case series in a tertiary eye care center. Case records of patients diagnosed with VPT from 2011 to 2015 were reviewed, and their demographic details, clinical presentation, and treatment outcomes were documented. Baseline and follow-up visual acuity and tumor dimensions were statistically compared by applying paired t-test. Statistical analysis used SPSS version 14. Results: Twenty-two tumors from 19 eyes of 17 patients were included. Mean age at presentation was 43.5 years (range: 15–68 years). Mean presenting best-corrected visual acuity (BCVA) was + 1.10 logMAR. Sixty-eight percent eyes had secondary tumors. Most common association of secondary VPT was Coats disease followed by retinal vasculitis, polypoidal choroidal vasculopathy, familial exudative vitreoretinopathy, and traumatic chorioretinopathy. Ten tumors (45%) involved the inferior quadrant. Tumor-associated features were intra/subretinal exudates, vitritis, subretinal fluid, vitreous hemorrhage, preretinal fibrosis, epiretinal membrane, and subretinal blood. Treatment included cryotherapy, intravitreal or oral steroids, laser photocoagulation, cryotherapy with encirclage, cryotherapy with anti-vascular endothelial growth factor, and observation. Complications included tumor recurrence, retinal detachment, raised intraocular pressure, neovascularization of iris, and cataract. Ninety-five percent VPT regressed at mean 21 months (Median: 17 months; Range: 3–64 months). Mean final BCVA was + 1.21 logMAR. Conclusion: VPTs are commonly unilateral, unifocal, and located anterior to equator in inferior fundus. Secondary tumors are more common than primary tumors. Treatment achieves tumor regression in majority of cases.
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Affiliation(s)
| | | | - Pukhraj Rishi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Ekta Rishi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Lingam Gopal
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Tarun Sharma
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Muakkassa NW, Schwaber EJ, Laver N, Duker JS. Bilateral Myelinated Retinal Nerve Fibers Associated With Bilateral Vitreous Cysts and Solitary Vasoproliferative Tumor: A New Syndrome. Ophthalmic Surg Lasers Imaging Retina 2018; 49:356-359. [PMID: 29772046 DOI: 10.3928/23258160-20180501-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/01/2017] [Indexed: 11/20/2022]
Abstract
The authors report a case of a 57-year-old male with high myopia, extensive bilateral myelination of the retinal nerve fiber layer, bilateral vitreous cysts, and a solitary vasoproliferative tumor in the right eye. He underwent pars plana vitrectomy and multiple transpupillary thermotherapy treatments for recurrent vitreous hemorrhages and subretinal exudation from the vasoproliferative tumor. To the authors' knowledge, this is the first description of this constellation of findings and suggests this represents a new syndrome. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:356-359.].
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Abstract
We describe a case of a 65-year old man diagnosed with retinal vasoproliferative tumour secondary to posterior uveitis. The fluorescein angiography shows an interesting meteor-like leak emanating from the tumour and rising towards the superior retina in the later frames of the angiogram. Pictorially, we call it the “Retinal Meteor” and also describe the possible mechanism for this pattern of leakage.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Prachi Gurav
- Department of Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Prachi Abhishek Dave
- Department of Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Sankhadeep Roy
- Department of Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Nourinia R, Motevasseli T, Tofighi Z. Intravitreal bevacizumab role in the treatment of macular edema secondary to retinal vasoproliferative tumor in a patient with neurofibromatosis type 1. GMS OPHTHALMOLOGY CASES 2016; 6:Doc08. [PMID: 27703870 PMCID: PMC5039346 DOI: 10.3205/oc000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: To report a case of neurofibromatosis-1 (NF-1) with retinal vasoproliferative tumor (RVPT) and macular edema and exudation that was successfully treated with intravitreal bevacizumab (IVB). Method: A retrospective case report of patient with neurofibromatosis, retinal vasoproliferative tumor and macular edema who received three monthly intravitreal injections of bevacizumab. Optical coherence tomography (OCT) and fluorescein angiography (FAG) before and three months after treatment were done. Results: Macular edema and exudation of the right eye was effectively resolved with IVB injection and vascularity of RVPT significantly decreased after treatment with IVB. Conclusion: Macular edema and exudation secondary to RVPT in patients with NF-1 could be successfully treated with IVB.
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Affiliation(s)
- Ramin Nourinia
- Ophthalmic research center, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Tahmineh Motevasseli
- Ophthalmic research center, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Zahra Tofighi
- Ophthalmic research center, Shahid Beheshti University of Medical Science, Tehran, Iran
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Marcelo-Tan MCT, Parsons HM. Retinal vasoproliferative tumour in an adolescent who had medulloblastoma: a case report. Can J Ophthalmol 2015; 50:e74-8. [PMID: 26455986 DOI: 10.1016/j.jcjo.2015.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 05/31/2015] [Indexed: 10/23/2022]
Affiliation(s)
| | - Hugh M Parsons
- University of British Columbia, Retina Surgical Associates, New Westminster; Surrey Memorial Hospital, Surrey, B.C., Canada.
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23
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Cryotherapy-induced release of epiretinal membrane associated with retinal vasoproliferative tumor: analysis of 16 cases. Retina 2014; 34:1644-50. [PMID: 24752009 DOI: 10.1097/iae.0000000000000137] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate epiretinal membrane (ERM) response after cryotherapy for retinal vasoproliferative tumors (VPTs). METHOD Retrospective interventional case series. RESULTS Of 16 eyes with VPT and ERM, the tumor was classified as primary in 12 (75%) eyes or secondary in 4 (25%) eyes. The median patient age was 44 years (mean, 43 years; range, 9-70 years). The tumor was located in extramacular zone (n = 16, 100%) and inferotemporal quadrant (n = 12, 75%). The mean tumor base was 6 mm, and thickness was 3 mm. The ERM involved the macula in 12 (75%) eyes and extramacular zone in 4 (25%) eyes, with best-corrected visual acuity of 20/40 or better in 6 (38%) eyes. Associated features included cystoid macular edema (n = 8, 50%), subretinal fluid (n = 10, 63%), vitreous cells (n = 9, 56%), and vitreous hemorrhage (n = 7, 44%). Single-session cryotherapy (double freeze-thaw) to the VPT was performed in each case. Over mean follow-up of 68 months (median, 54 months; range, 8-252 months), tumor regression was documented in 16 (100%) cases, with ERM release in 10 (63%) cases. After ERM release, the foveal anatomy was normal in 12 (75%) eyes. Final visual acuity improved (n = 5, 31%), remained stable (n = 9, 56%), or worsened (n = 2, 13%). Posttreatment best-corrected visual acuity was 20/40 or better in 10 (63%) eyes. CONCLUSION Cryotherapy is remarkably effective for VPT of 6 mm or less in basal dimension. After cryotherapy, VPT-related ERM spontaneously released in 63% of the cases, without the need for surgical intervention.
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Cebeci Z, Oray M, Tuncer S, Tugal Tutkun I, Kir N. Intravitreal dexamethasone implant (Ozurdex) and photodynamic therapy for vasoproliferative retinal tumours. Can J Ophthalmol 2014; 49:e83-4. [PMID: 25103664 DOI: 10.1016/j.jcjo.2014.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 03/30/2014] [Accepted: 04/07/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Zafer Cebeci
- Istanbul University, Istanbul Faculty of Medicine, Ophthalmology Department, Istanbul, Turkey.
| | - Merih Oray
- Istanbul University, Istanbul Faculty of Medicine, Ophthalmology Department, Istanbul, Turkey
| | - Samuray Tuncer
- Istanbul University, Istanbul Faculty of Medicine, Ophthalmology Department, Istanbul, Turkey
| | - Ilknur Tugal Tutkun
- Istanbul University, Istanbul Faculty of Medicine, Ophthalmology Department, Istanbul, Turkey
| | - Nur Kir
- Istanbul University, Istanbul Faculty of Medicine, Ophthalmology Department, Istanbul, Turkey
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Intravitreal bevacizumab in the treatment of vasoproliferative retinal tumours. Eye (Lond) 2014; 28:968-73. [PMID: 24875225 DOI: 10.1038/eye.2014.113] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 04/20/2014] [Indexed: 11/09/2022] Open
Abstract
AIM To evaluate the efficacy of intravitreal bevacizumab in the treatment of retinal vasoproliferative tumours (VPT). MATERIALS AND METHODS Six eyes of 6 patients with VPT who received intravitreal bevacizumab were retrospectively reviewed. All patients received between one and three injections of intravitreal bevacizumab depending upon response to treatment. Best-corrected visual acuity (BCVA), tumour size, and presence of co-pathology or sequelae were noted pre- and postoperatively and then analysed. Subsequent retreatments were performed in patients with recurrent or persistent VPT according to the ophthalmologist's discretion. Retreatments included photodynamic therapy with verteporfin, ruthenium-106 plaque brachytherapy, or endoresection of tumour. RESULTS The mean follow-up duration was 33.3 months (range 10-66 months). At baseline, the mean logMAR BCVA was 1.45 (Snellen equivalent of 6/165); range 0.10-1.90 (6/8-CF). Following bevacizumab treatment the mean logMAR BCVA was 0.98 (Snellen equivalent of 6/57); range 0.5-1.9 (Snellen equivalent of 6/19 to CF). Therefore, there was no statistically significant change in visual acuity. The mean tumour thickness reduced from 2.4 to 2.1 mm following treatment with bevacizumab. However, this did not reach the statistical significance of P<0.05. Despite the visual improvement following bevacizumab therapy, five out of six patients had recurrence of tumour activity during the follow-up period and required further intervention in order to achieve sustained regression. CONCLUSIONS Intravitreal bevacizumab appeared to result in temporary reduction of tumour thickness in 3 out of 6 VPT patients. However, neither the reduction in tumour thickness nor the change in visual acuity were statistically significant and intravitreal bevacizumab monotherapy had limited effectiveness in causing long-term regression of the lesions. Additional therapy was indicated in five out of six patients to establish long-term regression. The efficacy of bevacizumab as an adjunct is as yet undetermined and further studies are needed. Presently, we recommend other treatment modalities in the long-term management of VPTs.
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Saeed MU, Gkaragkani E, Ali K. Emerging roles for antiangiogenesis factors in management of ocular disease. Clin Ophthalmol 2013; 6:533-43. [PMID: 23515639 PMCID: PMC3601643 DOI: 10.2147/opth.s31016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The first antivascular endothelial growth factor (anti-VEGF) was developed as an anticancer drug for colonic carcinomas. Since then, anti-VEGFs have developed in scope and indications. They have revolutionized the treatment of exudative macular degeneration and have had a major impact on treatment of several other conditions. This has resulted in an increased number of patients seeking treatment with new treatment options and has had a considerable financial impact on health care resources. Anti-VEGFs have been used in the treatment of all age groups of the population ranging from infants where it is used for treatment of retinopathy of prematurity to the elderly where it is used in exudative macular eegeneration.
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Affiliation(s)
- Muhammad Usman Saeed
- The Sutton Eye Unit, Epsom and St Helier’s University Hospitals NHS Trust,
London, UK
| | - Evangelia Gkaragkani
- The Sutton Eye Unit, Epsom and St Helier’s University Hospitals NHS Trust,
London, UK
| | - Kashif Ali
- Department of Ophthalmology, Countess of Chester Hospital NHS Foundation Trust,
Chester, UK
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Ayres B, Bretana ME, Dubovy S, Schefler AC. Mushroom-shaped secondary vasoproliferative tumor. Ophthalmic Surg Lasers Imaging Retina 2012; 43 Online:e104-6. [PMID: 23053849 DOI: 10.3928/15428877-20120927-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 08/09/2012] [Indexed: 11/20/2022]
Abstract
The authors report a clinical and echographic correlation of a retinal vasoproliferative tumor that assumed a mushroom shape. A 64-year-old man with a history of retinal detachment repair presented with vitreous hemorrhage. A clinical examination including standardized ultrasound was performed, which revealed a mushroom-shaped tumor with high reflectivity. The patient underwent pars plana vitrectomy with fine needle aspiration biopsy. Histopathology of the biopsy specimen demonstrated vascular proliferation. The lesion was diagnosed to be a retinal vasoproliferative tumor. Clinicians should be aware that a mushroom-shaped configuration can be seen in such cases, although it is common for uveal melanoma.
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Affiliation(s)
- Bernadete Ayres
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL 33136, USA.
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Ziemssen F, Heimann H. Evaluation of verteporfin pharmakokinetics--redefining the need of photosensitizers in ophthalmology. Expert Opin Drug Metab Toxicol 2012; 8:1023-41. [PMID: 22762303 DOI: 10.1517/17425255.2012.701617] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The benzoporphyrine derivative verteporfin has lost its importance to the treatment of the most frequent neovascular eye diseases. Nevertheless, it is still mandatory to define the remaining applications, role, and potential of verteporfin in ocular photodynamic therapy (PDT), including the dosages of administration, effectiveness, and safety profile. AREAS COVERED Although verteporfin PDT has forfeited the first-line status and value of treating subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration or pathologic myopia, the treatment remains the standard of care for choroidal haemangioma and polypoidal choroidal vasculopathy. PDT is effective in less pigmented choroidal melanoma as well as in retinal vascular proliferations and retinal angioma. Verteporfin was granted the orphan drug designation for the treatment of chronic or recurrent central serous chorioretinopathy (CSC). EXPERT OPINION Evidence-based data regarding optimized parameters (low fluence, reduced dose, fractionated irradiation) adapted to the treated diseases (target structure, dosimetry, blood supply) are scarce. Prospective and large clinical trials are missing, although the scientific community agrees on the fact that the standard treatment protocol does not necessarily provide the optimal efficacy to the specific disease or individual patient. Within the reviewed indications, the adverse effect profile is favorable compared with other therapies.
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Affiliation(s)
- Focke Ziemssen
- Eberhard Karl University Tuebingen-Center for Ophthalmology, Schleichstr. 12, Tuebingen 72076, Germany.
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Smith J, Steel D. The Surgical Management of Vasoproliferative Tumours. Ophthalmologica 2011; 226 Suppl 1:42-5. [DOI: 10.1159/000328209] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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