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Published byMarshall Johnston Modified over 8 years ago
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VASOPROLIFERATIVE TUMOURS OF THE RETINA Eye (2003) 17, 364-368 K Jain, AR Berger, YH Yucil, HD McGowan
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CASE 1 64y, white, female ?MM VA ® 6/52 post-op cataract (uneventful) (L) Laser Rx for retinal tear 5y ago VA: 3/60, 6/12 IOP: 24, 16 ® RAPD (+1) ® shallow subtotal exudative RD+ lipid ® orange elevated mass 1 o’clock (SN)/ Vit.: +++ cells B-scan: internal reflectivity/ CT: NAD 3/12 after: rubeosis+ vit haemorrhage Rubeotic glaucoma: enucleation Histopathology: proliferation of elongated cells+ vessels, no mitoses, no atypia, glial cell origin (gfap,S-100, vimentin)
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CASE 2 67y, healthy Indian male ? MM Floaters MI 12y ago/ ® blunt injury ?haemorrhage ® -9.00D 6/12, (L) –5.00D 6/6 ® fundus: orange grey oval shaped mass+ surface NV+Haem. Between ora-equator, no surrounding vessel tortouosity- dilatation B-scan: no acoustic hollowness, no choroidal excavation base:5x4mm, height: 1.2mm 5y FU: no new symptoms, no change in base, height: 1.9mm in exudate, haemorrhage, pigmentary changes
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CASE 3 30y, healthy male ® floaters 1/12 post blunt trauma+ laser Rx for ? Ret. Tear VA: 6/6 R+L ® : round greenish-yellow exudative raised lesion in IT periphery+ overlying vit haemorrhage B-scan: internal reflectivity/ solid Rx: Cryo 2/52 post:6/18 ERM 3/12:6/9 FU at 6/12: stable VA/ no complications/ no complaints
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COMMENTS VTPR Benign reactive gliovascular proliferation Unilateral/ solitary/ no family history/ older Periphery (IT)/ No dilated feeder-draining vessels Not associated with tumours elsewhere Reddish yellow/ peach coloured Exudation/ haemorrhage Macular oedema/ ERM Rubeosis Diagnosis: clinical, B-scan, POH, Family history
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DD 1.Ret. Capillary haemangioma 2.Coats 3.PEHC 4.MM 5.Metastasis 6.Post. scleritis
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FU Need periodic FU due to sight threatening complications Post cataract Post trauma
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Rx Observation Cryo Laser Plaque radiotherapy PDT Thermotherapy TPPV for TRD-ERM Trans-scleral resection Macular pucker: improves sponaneously, delay vity for at least 3/12 after cryo
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