Objective: To evaluate the treatment of vasoproliferative
tumors of the retina (VPTR). Methods: Retrospective case series study. The clinical data of 20 VPTR patients (20 eyes) were retrospectively analyzed, including 2 eyes only treated by
cryotherapy, 1 eye only treated by
photocoagulation and 1 eye only treated by
ruthenium-106 brachytherapy. The remaining 16 eyes had combined treatment of
ruthenium-106 brachytherapy,
photodynamic therapy, anti-
VEGF therapy,
photocoagulation and
cryotherapy. Nine eyes were also treated by
vitrectomy because of complications such as
retinal detachment and
vitreous hemorrhage. Results: Single or multiple yellow white or orange red, highly vascular
tumor lesions were found in ocular fundi of the 20 eyes. All eyes were accompanied by complications, including intraretinal and subretinal exudations (100%),
macular edema (n=19, 95%),
epiretinal membrane (n=4, 20%),
retinal detachment (n=8, 40%),
vitreous hemorrhage (n=6, 30%), abnormal blood vessels (n=16, 80%) and proliferative membrane (n=7, 35%). In the follow-up, the
tumor in the eye treated by
ruthenium-106 brachytherapy alone was atrophied and the vision improved. Regarding the 2 eyes treated by
cryotherapy alone,
macular edema and abnormal blood vessels decreased and visual acuity improved in 1 eye, and visual acuity did not change significantly in another eye. More leakages and increased visual acuity were found in the eye treated by
photocoagulation alone. Among the 16 eyes treated with combined
therapy, 9 eyes had decreased complications and improved visual acuity, 3 eyes did not change significantly, and 2 eyes had increased complications and decreased visual acuity. Conclusions: The conditions of VPTR are complex and difficult to treat. According to the specific conditions, clinicians should choose appropriate treatment methods; different treatment methods can be combined.
Laser photocoagulation and
cryotherapy may be chosen to treat small
tumors complicated with abnormal blood vessels.
Ruthenium-106 brachytherapy could treat big
tumors complicated with exudative
retinal detachment. Vitreous surgery can be used in
hemorrhage and tractional
retinal detachment. Anti-
VEGF therapy is effective in the treatment of
macular edema. (Chin J Ophthalmol, 2020, 56:272-278).