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Shatskikh AV, Yarovoy AA, Gorshkov IM, Gorodetskaya YB. [Morphological features of vasoproliferative tumor of the retina]. Arkh Patol 2024; 86:42-50. [PMID: 38591906 DOI: 10.17116/patol20248602142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
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.
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Affiliation(s)
- A V Shatskikh
- S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - A A Yarovoy
- S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - I M Gorshkov
- S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Yu B Gorodetskaya
- S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
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Ramamurthy SR, Dave VP, Chou HD, Ozdek S, Parolini B, Dhawahir-Scala F, Wu WC, Ribot FMD, Chang A, Ruamviboonsuk P, Pathengay A, Pappuru RR. Retinotomies and retinectomies: A review of indications, techniques, results, and complications. Surv Ophthalmol 2023; 68:1038-1049. [PMID: 37406778 DOI: 10.1016/j.survophthal.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023]
Abstract
Retinotomy refers to "cutting" or "incising" the retina, whereas retinectomy denotes "excising" the retina. Retinotomies and retinectomies aid in tackling traction and retinal shortening that persist following membrane dissection and scleral buckling. We performed a literature search using Google Scholar and PubMed, followed by a review of the references procured. All relevant literature was studied in detail and summarized. We discuss the indications of retinotomies and retinectomies for relaxing retinal stiffness, accessing the subretinal space for choroidal neovascular membrane, hemorrhage and abscess clearance, drainage retinotomies to allow retinal flattening, radial retinotomies to release circumferential traction, harvesting free retinal grafts, and prophylactic chorioretinectomies in trauma.
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Affiliation(s)
- Srishti Raksheeth Ramamurthy
- Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India; Standard Chartered-LVPEI Academy for Eye Care Education, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
| | - Vivek Pravin Dave
- Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
| | - Hung-Da Chou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Sengul Ozdek
- Department of Ophthalmology, Gazi University School of Medicine, Ankara, Turkey
| | | | | | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | | | - Andrew Chang
- Sydney Retina Clinic & Sydney Eye Hospital, Sydney, NSW, Australia; The University of Sydney, Camperdown, NSW, Australia
| | - Paisan Ruamviboonsuk
- College of Medicine, Rangsit University, Lak Hok, Thailand; Center of Excellence for Vitreous and Retinal Disease, Rajavithi Hospital, Bangkok, Thailand
| | - Avinash Pathengay
- GMR Varalakshmi Campus, Retina and Uveitis Service, Anant Bajaj Retina Institute, Visakhapatnam, Andhra Pradesh, India
| | - Rajeev Reddy Pappuru
- Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
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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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Kiri H, Raval V, Ali H, Das AV, Kaliki S. Vasoproliferative retinal tumors: Clinical presentation and treatment outcome. Eur J Ophthalmol 2022:11206721221149075. [PMID: 36575603 DOI: 10.1177/11206721221149075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To study the clinical presentation and treatment outcomes of patients with vasoproliferative retinal tumor (VPRT) in India. METHODS Retrospective study of 50 eyes in 47 patients. RESULTS Of the 50 eyes, 25 (50%) were primary and 25 (50%) were secondary. Common ocular pathologies related to secondary VPRT included retinal detachment (n = 8, 32%) and Coats disease (n = 7, 28%). Overall, the mean age at presentation was 35 years (range; 3-74 years) and included 30 (64%) males and 17 (36%) females. The lesions were unilateral in 44 (94%) patients. Secondary retinal features included intra/subretinal exudation (n = 41, 82%), vascularity (n = 32, 64%), subretinal fluid (n = 21, 42%), retinal neovascularisation (n = 9, 18%) and vitreous hemorrhage (n = 8, 16%). Thirty-four eyes (68%) underwent cryotherapy, of which 16 eyes (47%) received adjunct intravitreal anti-VEGF (12 eyes) or corticosteroid injection (4 eyes). Primary surgery included vitrectomy with/without encirclage and cryotherapy (n = 12, 24%) and plaque brachytherapy (n = 3, 6%). At last follow-up (mean 9.7 months, range 3-67 months), 42 eyes (84%) had complete tumor regression with no improvement in visual outcomes when comparing presenting and final best corrected visual acuity. Comparing primary versus secondary VPRT, secondary VPRT presented a decade earlier (31 vs 40 years), needed surgical intervention (48% vs 20%), had poor tumor control (72% vs 92%) and worse visual outcomes (p < 0.05). CONCLUSION VPRTs commonly present as a unilateral lesions in the adult population with equal prevalence of primary and secondary variants. Compared with primary VPRT, secondary VPRTs require surgical treatment and are associated with poor visual outcome.
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Affiliation(s)
- Hardik Kiri
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Vishal Raval
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India.,The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Hasnat Ali
- Center for Biostatistics and Epidemiology, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anthony Vipin Das
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India.,Indian Health Outcomes, Public Health and Economics Research Center, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, Telangana, India
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SURGICAL OUTCOMES OF VASOPROLIFERATIVE RETINAL TUMORS' REFRACTORY TO NONINVASIVE THERAPIES. Retina 2022; 42:1772-1779. [PMID: 35994586 DOI: 10.1097/iae.0000000000003520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the outcomes of surgical treatment of refractory vasoproliferative retinal tumors (VPTs) and its complications. METHODS Clinical charts of all patients diagnosed with VPTs who underwent surgical treatment from 2005 to 2020 were reviewed. Clinical features, surgical techniques, and outcomes were evaluated. RESULTS From 25 eyes of 23 patients with VPTs, 17 (68%) eyes underwent surgical intervention to treat tumor activity and associated complications including epiretinal membrane (n = 10, 59%), retinal detachment (n = 8, 47%), and vitreous hemorrhage (n = 3, 18%). All eyes underwent pars plana vitrectomy with endolaser/cryotherapy to control tumor activity and to treat associated complications. Three cases required tumor resection. At the end of follow-up (mean 55.4 months, range 2-305 months), no eye presented tumor activity or retinal detachment after one or two surgeries. There was no epiretinal membrane recurrence. The mean baseline best-corrected visual acuity was 1.2 ± 0.7 logMAR, and the mean final best-corrected visual acuity was 0.7 ± 0.6 logMAR ( P < 0.05). The best-corrected visual acuity improved two or more lines in 12 (70.5%) eyes at the end of follow-up. CONCLUSION In this series of patients with large active VPTs, surgical intervention allowed control of the tumor activity in all patients and provided overall satisfactory anatomic and functional outcomes.
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Tong L, Jia Y, Wang J, Li Y, Chen Z, Liu S, Zhang L. Case Report: Exacerbation and Spontaneous Separation of the Epiretinal Membrane Following Laser Photocoagulation of a Vasoproliferative Tumor of the Retina. Front Med (Lausanne) 2022; 9:770689. [PMID: 35280881 PMCID: PMC8914037 DOI: 10.3389/fmed.2022.770689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
The present report concerns a rare vasoproliferative tumor of the retina (VPTR) combined with a severe case of secondary epiretinal membrane (ERM). A 56-year-old male patient was diagnosed with VPTR and secondary ERM of the left eye. The patient underwent two rounds of laser photocoagulation (LP) of the tumor. The exacerbation of the ERM was observed after the first round of LP, while spontaneous separation over the five-month follow-up period was noted after the second round of LP. Thus, LP may represent a viable alternative treatment approach for VPTR combined with severe ERM.
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Affiliation(s)
- Luyao Tong
- Department of Ophthalmology, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
- Eye Center of Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yujie Jia
- Eye Center of Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Ophthalmology and Otorhinolaryngology, Shaoxing Shangyu Women and Children Hospital, Shaoxing, China
| | - Junliang Wang
- Eye Center of Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Ningbo Eye Hospital, Ningbo, China
| | - Yan Li
- Eye Center of Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Hangzhou Linping Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, China
| | - Zhiqing Chen
- Eye Center of Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Shelan Liu
| | - Li Zhang
- Eye Center of Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Li Zhang
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Schmelter V, Fuerweger C, Muacevic A, Priglinger SG, Foerster P, Liegl R. Robotic-assisted radiosurgery for the treatment of vasoproliferative tumours. Acta Ophthalmol 2021; 99:456-460. [PMID: 33280249 DOI: 10.1111/aos.14609] [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: 01/16/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Vasoproliferative tumours (VPT) are a rare but benign entity that can lead to severe visual acuity deterioration. There is no standard of care, and depending on the degree of clinical features, including tumour size and dissemination, visual acuity and subretinal fluid, treatment options include observation, cryotherapy and brachytherapy. Particularly in larger tumours, brachytherapy has advantages over other options, although higher radiation doses and the need for surgical application are disadvantages of this otherwise effective treatment option. CyberKnife radiosurgery might represent an alternative therapeutic option as no surgical intervention is needed and radiation doses are lower. METHODS All patients diagnosed with vasoproliferative tumors who were treated with CyberKnife radiosurgery with a minimum follow-up time of 12 months were included in this case series. We recorded visual acuity, number of lesions, central retinal thickness with optical coherence tomography (OCT) and reflectivity using A-scan standardizes echography every three months. RESULTS A total of four patients with a median age of 34 years (range: 24 - 51) who were observed over an average of 26.5 months (range: 17 - 49 months) matched our inclusion criteria. We appreciated stabilization or increase in visual acuity in all four patients and a regression in tumour thickness with subsequent increase in internal reflectivity as a marker of increasing fibrosis. CONCLUSION We observed good visual and functional outcome following CyberKnife therapy for VPT. We believe that further studies should be pursued to evaluate CyberKnife therapy for the treatment of VPT not treatable with cryo- or lasertherapy.
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Affiliation(s)
- Valerie Schmelter
- Department of Ophthalmology Ludwig‐Maximilians University Munich Germany
| | - Christoph Fuerweger
- European CyberKnife Center Munich Germany
- Center for Neurosurgery Department of Stereotaxy and Functional Neurosurgery University of Cologne Cologne Germany
| | | | | | - Paul Foerster
- Department of Ophthalmology Ludwig‐Maximilians University Munich Germany
| | - Raffael Liegl
- Department of Ophthalmology Ludwig‐Maximilians University Munich Germany
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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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