علاج ورم الأوعية الدموية الشبكية خارج الحليمة بقطر يزيد على 4.5 مم

References

DOI: 10.1097/IAE.0000000000002572

• Extrapapillary RH greater than 4.5 mm in diameter pose a difficult challenge, with decreasing rates of success and increasing risks of treatment with increasing tumor size.
• Some have found that cryotherapy can sometimes be effective for lesions this size, in cases where it can be used with sufficiently low risk, but there is concern about the degree of exudation and vitreous contracture that can occur after treatment.
• Some of us consider brachytherapy for these large, high-risk tumors, while others typically offer vitrectomy with endocryotherapy or with excision of the tumor.
• Excision of an RH requires attention to intraocular hemostasis, which can include treatment of the lesion with endolaser photocoagulation, followed by diathermy to feeding vessels under high intraocular pressure prior to excision, or ligation of feeder vessels with intraocular suture prior to excision.
• Retinopexy is applied to the region of retinectomy, with use of gas or oil tamponade.
• Five years after vitrectomy with tumor excision and epiretinal membrane peeling, a scar without any vestige of the retinal hemangioblastoma is present at the site of retinectomy, exudation has completely resolved, and the feeding/draining vessels are reduced to ghost vessels.