Vasoproliferative tumour (VPT) is an uncommon and challenging complication of chronic uveitis. We report key clinical and multi-modal imaging findings in a series of adult and adolescent patients.
Patients with VPT in Manchester Uveitis Clinic, UK were reviewed. The clinical features and serial imaging findings, including ultra-widefield retinal analysis with fluorescein angiography (FA) and autofluorescence and optical coherence tomography (OCT), were analysed.
A total of 6 eyes from 6 patients were identified (4 male). Mean age at diagnosis of uveitis was 36.5 yrs. (range 8-59). 5/6 patients had intermediate uveitis and 1, juvenile onset panuveitis. At diagnosis of VPT the mean age was 42.5 ± 17.7 years, visual acuity ranged from 0.0-1.10 and all eyes had active uveitis. The most common location was inferotemporal (4 out of 6 eyes).Each exhibited a retinal mass with exudate, subretinal fluid and haemorrhage identified through clinical examination and multimodal imaging. Macular oedema was observed in 4 eyes and epiretinal membrane in 3 eyes. FA showed a hyperfluorescent mass in mid-frames and late leakage in eyes; non-occlusive peripheral vasculitis in 3 eyes and occlusive vasculitis in 1. Treatment included local steroid in 4 eyes (3 intravitreal; 1 periocular); cryotherapy in 3 eyes and PDT in 2 eyes and all patients received systemic immunosuppression. Visual acuity at final follow-up (mean>5yrs) ranged from 0.1-0.6.
The diagnosis and monitoring of VPT can be assisted by wide-field imaging, which should guide management decisions of patients with uveitis to prevent further progression of this complication.