Clinical Profiles of Retinal Vasoproliferative Tumors

Abstract

Purpose: To describe the clinical features and treatment outcomes of patients with retinal vasoproliferative tumors. Methods: This retrospective case series comprised patients diagnosed with a retinal vasoproliferative tumor. Electronic medical records were reviewed, and patients' demographic details, clinical presentation, and treatment outcomes were analyzed. Results: Nineteen eyes of 19 patients with vasoproliferative tumors were included. The mean age (±SD) at presentation was 37.0 ± 16.95 years. No eye had bilateral tumors, and 1 eye had multiple tumors. Three eyes (15%) had primary tumors, while 16 (84%) had secondary tumors. Primary tumors mainly affected the inferotemporal quadrant (n = 3). Secondary tumors involved the inferior quadrant (n = 4), inferotemporal quadrant (n = 5), and inferonasal quadrant (n = 5). Secondary tumors were associated with Coats disease (n = 6), intermediate uveitis (n = 3), traumatic chorioretinopathy (n = 2), familial exudative vitreoretinopathy (n = 2), retinal vasculitis (n = 2), and retinal vascular occlusion (n = 1). Retinochoroidal features included intraretinal and subretinal exudates, subretinal fluid, intraretinal hemorrhaging, vitreous hemorrhaging, cystoid macular edema, vitritis, preretinal fibrosis, dilated feeding vessel, epiretinal membranes, and tractional retinal detachment. Treatment modalities included cryotherapy, laser photocoagulation, and local steroids. The mean follow-up was 25.3 months, during which 18 eyes had tumor regression and 1 had a worsening condition. Conclusions: Secondary vasoproliferative tumors were more frequently observed than primary tumors, often presenting as unilateral, unifocal tumors situated posterior to the equator in the inferior fundus. Conventional treatment approaches, such as cryotherapy and laser photocoagulation, were effective at tumor regression and often required multiple sessions.

Keywords: eye; retina; tumor; vasoproliferative tumor.

Figure 1.

Optos imaging of vasoproliferative tumors (black arrows). (A) A secondary vasoproliferative tumor is seen in the inferior quadrant of the left eye. A telangiectatic vessel is accompanied by a major artery and vein directed toward the lesion. (B) A secondary vasoproliferative tumor located superiorly with large vascular channels is seen in the right eye.

Figure 2.

Optos imaging of a 45-year-old man with a vasoproliferative tumor secondary to Coats disease. (A) The tumor is located along the inferior arcade (black arrow). (B) Widefield fundus fluorescence angiography shows hyperfluorescence of the lesion that increases in intensity. (C) Areas of capillary nonperfusion are seen in the inferior quadrant.

Figure 3.

(A) Fundus imaging of the left eye before treatment of a vasoproliferative tumor (black arrow) secondary to adult-onset Coats disease in a 55-year-old man. (B) Regression of the tumor (black arrow) is seen after treatment with cryotherapy and systemic steroids.