VASOPROLIFERATIVE TUMOURS OF THE RETINA

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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 oclock (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 NVHaem. Between ora-equator, no
surrounding vessel tortouosity- dilatation
B-scan no acoustic hollowness, no choroidal
excavation base5x4mm, 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 RL
round greenish-yellow exudative raised lesion in
IT periphery overlying vit haemorrhage B-scan ?
internal reflectivity/ solid Rx Cryo ?2/52
post6/18 ? ERM ?3/126/9 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