Vasoproliferative tumors of the retina: Clinical features, complications, management and outcomes of 43 patients

Author: Fernando Trejo (Spain)

Co-authors: Fernando Trejo, Randa Falah, Sandra Banderas, David Aragón, Laura Distefano, José García Arumí

Purpose

The aim of this study was to review and describe the clinical features, etiology, management and outcomes of 43 consecutive patients with vasoproliferative tumor of the retina (VPT)

Setting/Venue

Ocular Oncology Services of the Retina Department in Vall d'Hebron Hospital and in Ocular Microsurgery Institute (IMO) Barcelona, Spain.

Methods

Clinical records of 43 patients treated at the two centers from 1999 through 2018 were reviewed. Main outcome measures included: type of treatment, visual threatening complications, retreatments needed, tumor regression and final visual acuity. Forty-three patients (46 eyes) aged from 26 to 88 years (mean 55.7) with VPT were included in the study. 21 patients were females, and 22 patients were males. Mean age at presentation was 40.82 years with a follow up period between 1 and 16 years.

Results

Primary VPT occurred in 58.69% (n = 27) and secondary VPT in 41.3% (n = 19) of patients. Pars planitis was the main pre-existing ocular disease in secondary VPT (42.1%). Patients consulted mainly for vision loss (43.47%) followed by myodesopsias (19.56%). Most frequent visual threatening complications included serous retinal detachment (n=17), vitreous hemorrhage (n= 11), epiretinal membrane (n = 10), posteriorly extending hard exudates (n =9) and macular edema (n=8). Treatment consisted in vitrectomy with endophotocoagulation (n =19), cryotherapy (n=7), slit lamp photocoagulation (n=13) and observation (n=7). Although 20.51% (n=8) of the treated VPT presented a recurrence after primary regression, final regression was observed in all treated cases. A total of 16 eyes (41.02 %) of all treated patients required at least 1 retreatment. When divided into primary and secondary VPT, Visual acuity (VA) of 67.85% of primary VTP eyes (n= 19) were found to be improved or unchanged at last follow-up with a median VA of 20/40 while only 55.55% of the secondary VPT eyes (n = 10) presented similar results with a median VA 20/50.

Conlusions

Vasoproliferative tumors of the retina are benign, acquired vascular tumors. Most are primary tumors, but in some cases a preceding ocular disease is present. They have heterogeneous evolutions from being asymptomatic to complete visual loss. Therefore, needs to be tailored according to the VA and the visual threatening complications.

Financial Disclosure

no financial disclosure