First Author: N.Souad ALGERIA
Co Author(s): I. Aicha D. Rafik M. Khadidja S. Bouchra Houaria
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To describe a clinical case about a monophtalmic patient who presented a idiopathic vasoproliferative retinal tumor (VPTR) associated with a exudative retinal detachement treated surgically after ten years of following up.
Work carried out at departement of ophtalmology Hammou Boutlélis clinic of ophtalmology-Oran-Algeria
A 34 year old male patient, with no family histories included neurologic vascular or ophtalmological disease, followed in our departement since 2004 for a bilateral retinal detachment. The story began at age of 24, he was admitted for a retinal detachment by a giant tear operated on the right eye with endocular surgery, during a systematic examination and prophylactic laser treatment of the left eye, an orange grey oval shaped intraretinal lesion that appeared in the inferotemporal periphery with a located exudative retinal detachment and surface microvascular, telangiectatic changes. This patient was followed up for Ten years without any further symptoms and stable lesion on the left fundus.
In 2014, a profound loss vision was detected in the left eye: BVCA was counting fingers at 10cm, anterior segment examination revealed granulomatous uveitis signes on slit lamp biomicroscopy however in the left fundus a massive exudative retinal detachment was found affecting all four quadrants and increase volume of the lesion with increase in surrounding exudates and telangiectatic changes, there were also numerous cells seen in the vitreous, ultrasound B scan showed a high signal and high internal reflectivity, the MRI of the brain talked about a suspecious melanoma. So we promptly performed vitrectomy endolaser, cryotherapy and silicone oil tamponade, four months a removal of the silicone was done and serval sciences of the laser was add it, there was a gradual resolution of the exudation and complete diseappear of the lesion in the left fundus.the BAVC improved to 2/10 in 6months after surgery and this was mainted for 3 years until the last visit.
It is important to recognize VPTR as clinically distinct lesions,which should be followed up periodically as they may lead to visual loss because of their exudative tendencies and other associated complications,thes lesion should be differentiated from other vascular or tumors lesions of the ocular fundus with our case, the surgery allowed us to confirm the nature of the lesion and the treatment in the same time.