P 697Vasoproliferative retinal tumors and their different treatment in a pair of female monocygotic twins
J. Wachtlin, H. Heimann, C. Jandeck, U. Kellner, M. H. Foerster
Background: Vasoproliferative retinal tumors are rare and mostly located in the fundus periphery. There are idiopathic forms or tumors secondary to diseases like uveitis or retinitis pigmentosa. The differential diagnosis is difficult and different therapeutic options have been applied.
Material and methods: We present the cases of a monocygotic pair of female twins, who received treatment for vasoproliferative retinal tumors in our hospital.
Case report: Both 58-year-old females presented with multiple peripheraly located vasoproliferative retinal tumors. Regarding the size and the location, the tumors appeared almost identically in the inferior and nasal quadrant on both eyes. Besides the exudates we could observe multiple pigment epithelium hyperplasias, scars and on the left eye respectively an exudative retinal detachment.
Therapy: Because of the extensive retinal detachment and the smal tumor height, one women was first treated with an encircling band and cryotherapy of the exudative lesion, which was followed by a pars plana vitrectomy and silicone oil later on. Her twin sister was treated twice with radiation by ruthenium plaque for a 4.6 mm prominent vasoproliferative tumor.
We show the follow up with photographic, echographic, fluorescein-angiographic and electrophysiological findings after the different treatment modalities.
Conclusion: The differential diagnosis of vasoproliferative tumors is difficult. Concerning the location of the tumors, the presented twins showed almost identical cases, which could be an indication that the cause of this disease might be a mutation or hereditary, although the parents and the children have not been affected. Therapeutic options have to be carefully selected in the indiviual case based on the clinical findings.
Augenklinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, D-12200 Berlin.