Vasoproliferative tumours of the retina

BACKGROUND Vasoproliferative tumours of the retina (VPTR) are benign tumours of unknown origin, occurring mostly in otherwise healthy patients. VPTR may be associated with other chorioretinal diseases, such as uveitis. The tumours, which histologically represent reactive gliovascular proliferations,...

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Bibliographic Details
Published in:British journal of ophthalmology 2000-10, Vol.84 (10), p.1162-1169
Main Authors: Heimann, Heinrich, Bornfeld, Norbert, Vij, Oliver, Coupland, Sarah E, Bechrakis, Nikolaos E, Kellner, Ulrich, Foerster, Michael H
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Biopsy
Brachytherapy
Cataracts
Cryosurgery
Family medical history
Female
Fluorescein Angiography
Follow-Up Studies
Fundus Oculi
Hemangioma - diagnosis
Hemangioma - therapy
Hospitals
Humans
Macular degeneration
Male
Medical imaging
Medical sciences
Middle Aged
NMR
Nuclear magnetic resonance
Ophthalmology
Original articles - Clinical science
Radiation therapy
Retina
Retinal Neoplasms - diagnosis
Retinal Neoplasms - therapy
Treatment Outcome
Tumors
Tumors and pseudotumors of the eye, orbit, eyelid, lacrimal apparatus
Ultrasonic imaging
vasoproliferative tumours
Visual Acuity
Citations: Items that cite this one
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Summary:BACKGROUND Vasoproliferative tumours of the retina (VPTR) are benign tumours of unknown origin, occurring mostly in otherwise healthy patients. VPTR may be associated with other chorioretinal diseases, such as uveitis. The tumours, which histologically represent reactive gliovascular proliferations, are characterised by a pink to yellow appearance on funduscopy and are accompanied by exudative and haemorrhagic changes of the retina. METHODS 22 cases of VPTR in 21 patients were examined with a follow up period between 1 month and 6 years. Ophthalmological changes associated with VPTR were intraretinal and subretinal exudations (n=18), exudative detachments of the surrounding sensory retina (n=13), intraretinal and subretinal haemorrhages (n=10), exudative changes within the macula (n=10), hyperpigmentation of the retinal pigment epithelium at the border of the exudative retinal changes (n=9), and vitreous haemorrhages (n=4). Tumour biopsy was performed in two cases. Treatment consisted of plaque radiotherapy (n=14), plaque radiotherapy and cryotherapy (two), cryotherapy only (two), observation (three), and enucleation in one case of a blind and painful eye. RESULTS Regression of the tumour and the associated exudative changes could be observed in all treated cases. Visual acuity at last follow up improved two lines or more in two cases, remained within two lines of the initial visual acuity in 15 cases, and worsened in the remaining five. Histopathological examination of the biopsy specimens and the tumour of the enucleated eye showed massive capillary proliferation with perivascular spindle-shaped glial cells of retinal origin. CONCLUSION The correct diagnosis of VPTR is of importance as these lesions may lead to visual loss. Further, VPTR must be differentiated from angiomas associated with von Hippel-Lindau disease as well as from ocular and systemic malignancies. Regression of tumour thickness and associated retinal changes can be achieved with brachytherapy or cryotherapy.
ISSN:0007-1161
1468-2079
DOI:10.1136/bjo.84.10.1162