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Vasoproliferative tumours of the retina

机译:视网膜血管增生性肿瘤

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摘要

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.

机译:背景—视网膜血管增生性肿瘤(VPTR)是来源不明的良性肿瘤,多发生于其他健康的患者中。 VPTR可能与其他脉络膜视网膜疾病(如葡萄膜炎)有关。在组织学上代表反应性胶质细胞增生的肿瘤,其特征是眼底镜检查呈粉红色至黄色外观,并伴有视网膜渗出和出血性改变。
方法—对21例患者中的22例VPTR进行了随访长达1个月至6年的时间。与VPTR相关的眼科变化包括视网膜内和视网膜下渗出物(n = 18),周围感觉视网膜的渗出性脱离(n = 13),视网膜内和视网膜下出血(n = 10),黄斑内渗出性改变(n = 10),渗出性视网膜改变(n = 9)和玻璃体出血(n = 4)边界处的视网膜色素上皮色素沉着过度。在两个病例中进行了肿瘤活检。一例盲眼疼痛的治疗包括斑块放疗(n = 14),斑块放疗和冷冻疗法(两次),仅冷冻疗法(两次),观察(三次)和摘除。
结果—在所有治疗的病例中都可以观察到肿瘤和相关的渗出性改变。最后随访的视力在2例中改善了2行或更多,在15例中保持在初始视力的2行以内,在其余5例中恶化了。对活检标本和去核眼的肿瘤进行组织病理学检查显示,视网膜来源的血管周围纺锤形胶质细胞大量毛细血管增生。
结论—正确诊断VPTR非常重要,因为这些病变可能导致视力丧失。此外,VPTR必须与与von Hippel-Lindau疾病相关的血管瘤以及眼部和全身性恶性肿瘤区分开来。近距离放射疗法或冷冻疗法可实现肿瘤厚度的消退和相关的视网膜改变。

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