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V. Krivosic, N. Benhamou, L. Desjardins, P. Le Hoang, R. Tadayoni, P. Massin, A. Gaudric; Management of Vasoproliferative Tumors of the Retina by Laser Photocoagulation. Invest. Ophthalmol. Vis. Sci. 2009;50(13):221.
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To report the efficacy of laser photocoagulation in treating vasoproliferative tumors of the retina (VPTR).
Retrospective non-comparative interventional case series. 27 patients (18 women and 9 men) with VPTR. Main outcome measures were best-corrected visual acuity (BCVA), the presence of intra or subretinal lipidic exudates, retinal detachment (RD), cystoid macular edema (CME) and epiretinal membrane (ERM). Laser photocoagulation was performed either on slit-lamp or during a pars plana vitrectomy on all the peripheral vascular telangiectasis visible at the surface of the VPTR.
Twelve patients were treated by slit-lamp laser photocoagulation. Mean follow up was 3 years (6 months to 10 years). Mean BCVA increased from 20/40 (CF to 20/20) before treatment to 20/32 (CF to 20/20) at the end of the follow up. No loss of vision was observed. Peripheral retinal lipidic exudation regressed completely in 8/12 cases. Fifteen patients underwent vitrectomy due to the presence of an ERM (9 cases), a large exudative RD (1 case), a reghmatogenous and exudative RD (3 cases), or a vitreous hemorrhage (2 cases). Mean follow up was 15 months (6 months to 7 years). Mean BCVA increased from 20/125 (CF to 20/50) before treatment to 20/50 (CF to 20/20) at the end of the follow up. No loss of vision was observed. The retina reattached in all cases. Retinal and subretinal exudates resorbed completely in 12/15 cases and significantly in the remaining 3. Post operative complications were reghmatogenous RD in 2 cases successfully reattached after additional surgery.
Selective laser photocoagulation of the peripheral retinal telangiectasis associated with VPTR induced in all our cases the regression of retinal exudation. Slit lamp laser photocoagulation have been sufficient in about half of the cases. In more severe conditions, large exudative retinal detachment, vitreous hemorrhage, or epiretinal membrane, vitrectomy was combined efficiently with direct endophotocoagulation of the telangiectasis.
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