Session Title: Quick Fire Free Paper 3
Session Date/Time: Thursday 11/09/2014 | 14:30-16:00
Paper Time: 15:55
Venue: Boulevard D
First Author: : S.Mahapatra INDIA
Co Author(s): : G. Kanungo
To describe the clinical features, visual outcomes, management options and ocular complications of patients with Retinal Angiomas.
A retrospective, non-comparative, observational case study of patients diagnosed with Retinal Angiomas was conducted in a tertiary eye care centre, Odisha, India. Twelve eyes of eight patients seen at our hospital from July 2006 to July 2013 were reviewed.
Data was collected retrospectively from patient records. General clinical features, including age at diagnosis, gender, physical examination, neurological examination, CT brain and renal ultrasound were reviewed. Any pedigree associated with von-Hipple-Lindau disease was recorded. The ophthalmic examinations included initial visual acuity, visual acuity at the final visit, the eye involved, tumor location, growth pattern, treatment modality including laser, Cryopexy, intravitreal Avastin, Vitreoretinal surgery or combination, ocular complications and follow up period. Initial fundus photographs, fundus fluorescein angiographs, OCT for macular edema were done and repeated when required during follow-up were reviewed.
In the 8 subjects, 12 eyes were identified with Retinal Angiomas. The mean follow-up time was 1.6 years. There were 5 males (8 eyes) and 2 females (4 eyes). The mean age at diagnosis for all patients was 27.7, that for men being 32.2 and for females being 17.3 years. The growth pattern of tumors was endophytic in all cases. The locations of the tumors included 6 in superior temporal retina, 4 in the inferior temporal retina and 2 in the temporal retina. Initial visual acuity ranged from hand movement to 6/36. Most patients with management retained their visual acuity before treatment except those with complicated exudative retinal detachment (RD). Eight eyes responded well to focal laser and intravitreal Avastin. Two patients received Cryotherapy after focal laser treatment due to persistent tumors. Three patients with Retinal Detachment or vitreous hemorrhage (VH) needed vitreoretinal surgery. According to the pedigree and systemic surveys, no patient met the diagnostic criteria of VHL disease though 3 members of a family suffered from diseases.
Ocular complications of retinal Angiomas include cystoid macular edema (CME), Secondary angiomatosis, epiretinal membrane (ERM), retinal neovasularisation and vitreous haemorrhage, exudative or tractional retinal detachment. Early diagnosis and treatment of retinal Angiomas with multimodal approach yields good visual outcome. If untreated the tumors may eventually have exudative RD and have a worse visual prognosis even with vitreoretinal surgery.