Management of Vasoproliferative Tumors of the Retina with Macular Complications by Pars Plana Vitrectomy Combined with Episcleral Cryotherapy

Author:

Zhang Wenhua1ORCID,Qiang Zeyuan1ORCID,Song Hao2ORCID,Li Xiaoli3ORCID,Dan Handong3ORCID,Ge Keke2ORCID,Li Pan2ORCID,Huang Zixu3ORCID,Wang Dongdong3ORCID,Chen Feng4ORCID,Zheng Bin4ORCID,Song Zongming3ORCID

Affiliation:

1. Henan University People’s Hospital, Henan Provincial People’s Hospital, Henan Eye Hospital, Zhengzhou 450003, Henan, China

2. Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Henan Eye Hospital, Zhengzhou 450003, Henan, China

3. Henan Eye Institute, Henan Eye Hospital, Henan Provincial People’s Hospital and Henan University People’s Hospital, Zhengzhou 450003, Henan, China

4. Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China

Abstract

Objective. To evaluate the efficacy of pars plana vitrectomy (PPV) combined with episcleral cryotherapy in treating vasoproliferative tumors of the retina (VPTR) with macular complications. Methods. In this retrospective noncomparative interventional case-series analysis, we included 11 eyes of ten patients diagnosed with VPTR. All patients underwent comprehensive ophthalmic examinations and were treated with PPV combined with episcleral cryotherapy. Best-corrected visual acuity (BCVA), tumor activity, retinal morphological structure, and postoperative complications were evaluated. Results. Macular complications included epimacular membrane (n = 10), macular hole (n = 3), and macular edema (n = 1). Tumors were treated with triple freeze-thaw episcleral cryotherapy during PPV. The mean logarithm of minimal angle of resolution (logMAR) BCVA dropped from 0.62 ± 0.58 to 0.39 ± 0.46. The difference between the mean values of logMAR BCVA before and after treatment was statistically significant (t = 2.48,P=0.033). The tumor activity was controlled effectively in nine cases. Compared with preoperative tumor activity, tumor activity after treatment was significantly lower (P<0.01). The increase of central retinal thickness and the disruption of retinal layers were associated with macular holes, macular edema, and retinal proliferative membrane. After the treatment, visual acuity improved in 91% of the cases, and 73% had no long-term complications. Conclusion. PPV combined with episcleral cryotherapy promoted tumor regression, preserved retinal integrity, and improved visual acuity. Thus, the combination of PPV with episcleral cryotherapy can be considered effective and safe for the management of VPTR with macular complications.

Funder

Key R & D and Promotion Program of Henan Province

Publisher

Hindawi Limited

Subject

Ophthalmology

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1. Ocular Complications of Intermediate Uveitis;Ocular Immunology and Inflammation;2024-07-18

2. Retinal vasoproliferative tumors;Retinal and Choroidal Vascular Diseases of the Eye;2024

3. Vasoproliferative retinal tumors: Clinical presentation and treatment outcome;European Journal of Ophthalmology;2022-12-27

4. SURGICAL OUTCOMES OF VASOPROLIFERATIVE RETINAL TUMORS' REFRACTORY TO NONINVASIVE THERAPIES;Retina;2022-09

5. Retinal vasoproliferative tumor regression after intravitreal aflibercept;Taiwan Journal of Ophthalmology;2022

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