Progress in diagnosis and treatment of retinal vasoproliferative tumor / 中华实验眼科杂志

Retinal vasoproliferative tumor (RVPT) is a rare benign glial proliferative tumor of unknown origin.The fundus is typically characterized by yellow or pink tumor-like lesions of the retina around the inferior temporal region, often accompanied by subretinal fluid, exudation, epiretinal membrane and other complications.Typical RVPT showed high fluorescence on fundus fluorescein angiography, diffuse leakage in venous phase and late stage, uneven middle or high reflection signal on B-ultrasound, and it was not difficult to diagnose combined with fundus changes.Atypical RVPT should be differentiated from retinal capillary hemangioma caused by von Hippel-Lindau disease, Coats disease and familial exudative vitreoretinopathy.The pathogenesis of RVPT is unclear, but histopathology shows that it may be the reactive proliferation of glial cells.At present, there is no unified treatment plan for RVPT, mainly cryotherapy, laser photocoagulation, local radiotherapy, transpupillary thermal therapy or photodynamic therapy for tumor.For patients with vitreous hemorrhage, vitreoretinal surgery is feasible.This article reviewed the clinical features, diagnosis and differential diagnosis, pathology and pathogenesis, and treatment progress of RVPT.

Vascular tumors of the choroid and retina.

Vascular tumors of the retina and choroid can be seen occasionally. In the following article, the key clinical and diagnostic features of the major retinal and choroidal vascular tumors, their systemic associations, and the literature pertaining to the most currently available treatment strategies are reviewed.

Brachytherapy of intra ocular tumors using ‘BARC I-125 Ocu-Prosta seeds’: An Indian experience.

Aim: To report our experience of brachytherapy using ‘BARC I‑125 Ocu‑Prosta seeds’ for the management of intraocular tumors with regard to tumor control, globe preservation visual outcome, and patient survival at Sankara Nethralaya, Chennai, India between September 2003 and May 2011. Materials and Methods: We reviewed records of 35 eyes of 35 patients who underwent ophthalmic brachytherapy between September 2003 and May 2011. Twenty‑one cases had choroidal melanoma, nine had childhood retinoblastoma, two had adult‑onset retinoblastoma, and there were one case each of vasoproliferative tumor, retinal angioma, and ciliary body melanoma. Brachytherapy was administered using a 15‑ or 20‑mm gold plaque with or without a notch. Brachytherapy was the primary treatment modality in all tumors other than retinoblastoma, wherein brachytherapy was done post chemoreduction for residual tumor. Results: For choroidal melanomas, the mean radiation dose was 68.69 ± 15.07 (range, 47.72-94.2) Gy. The eye salvage rate was 13/20 (65%) and tumor control rate was 16/20 (80%) at an average follow‑up of 24.43 ± 24.75 (range, 1.5-87.98) months. For retinoblastoma, the mean dose was 45.85 ± 3.90 (range, 39.51-50.92) Gy. The eye salvage rate and tumor control rate was 5/6 (83.3%) at an average follow‑up of 38.36 ± 31.33 (range, 4.14-97.78) months. All eyes with retinoblastoma needed additional focal therapy for tumor control and eye salvage. Conclusion: The results of this retrospective study confirms that the use of ‘BARC I‑125 Ocu‑Prosta seeds’ in episcleral plaques to treat intraocular tumors offers a viable option for the management of intraocular cancers.

Tumor vasoproliferativo de retina.: Reporte de dos casos / Vasoproliferative retinal tumor.: Report of two cases

El tumor vasoproliferativo de retina es una condición rara y benigna que presenta una lesión exudativa de retina periférica. La lesión puede ser clasificada en primaria (idiopática) o secundaria a otros procesos oculares. Las opciones terapéuticas incluyen observación, crioablación tisular, fotocoagulación láser, remoción quirúrgica mediante vitrectomía, terapia fotodinámica y braquiterapia epiescleral con isótopos radioactivos, asociadas o no al uso de antiangiogénicos o antiinflamatorios, siendo la elección de la modalidad de manejo particular en cada caso. Presentamos dos casos en pacientes femeninas portadoras de esta condición de los que describimos las características más importantes del cuadro clínico, retinografías, angiografía fluoresceínica y ecografía, así como el manejo y curso evolutivo-terapéutico.

Vasoproliferative retinal tumor is a rare and benign condition that presents as an exudative lesion in the peripheral retina. The lesion can be classified in primary (idiopathic) or secondary to other ocular processes. Therapeutic options include observation, cryotherapy, laser photocoagulation, surgical removal by pars plana vitrectomy, photodynamic therapy and epiescleral brachytheraphy with radio-active isotopes associated or not to the use of anti-angiogenic or anti-inflammatory drugs. The selection of a particular management modality depends on the type of case. Two female patients affected with this condition were presented; the most important characteristics in their clinical pictures, as well as the results of other tests as retinography, fluorescent and ICG angiography and echography were described. The management and the therapeutical and evolutive course of both patients were also discussed.