Retinal Vasoproliferative Tumors (VPTs) treatment: A 15-year retrospective study in a tertiary referral center in Iran

Purpose: To report the outcomes of different treatment modalities for vasoproliferative tumors (VPTs) of the ocular fundus in terms of anatomical and functional properties of tumor in a single referral ocular oncology center in IRAN.Methods: The clinical charts of all patients diagnosed with VPT from 2002 to 2017 were retrospectively reviewed. Clinical features, types of treatment, outcomes and complications were evaluated. Patients were divided to plaque radiotherapy group (A) and non-radiation group (B) (including Photodynamic therapy (PDT), Cryotherapy, Barrier laser photocoagulation and Vitrectomy).Results: We enrolled 46 eyes of 46 patients diagnosed with VPT in this study. Ru-106 plaque radiotherapy was done in 25 (54.3%) cases. Twenty eight patients (58.6%) were female. Mean age of patients was 40.9 ± 13.1 and 32.5 ± 13.3 in group A and B respectively (P=0.03). Eighteen (39.1%) had primary and 28 (60.9%) had secondary VPTs. In Group A, four different types of Ru-106 plaques were applied. Total apex dose (Gy) was 98.95±14.40 and total sclera contact dose (Gy) was 412.26±113.66. In group B, three types of treatment were used as cryotherapy ±intravitreal bevacizumab in 7(33%), cryotherapy +vitrectomy in 10 (48%), and PDT in 4(19%) patients. Initial tumor thickness was 4.27 ± 1.10 mm in group A versus 4.40 ±1.45 mm in group B (P> 0.05). ostoperatively, the mean tumor thickness decreased to 2.60 ± 0.63 mm in group A and to 2.56 ± 1.62 mm in group B (P<0.001 in both groups and P=0.9 between groups). Tumor regression was considered as at least 1 mm decrease in tumor thickness and decrease in subretinal fluid and macular exudation, which was achieved in both treatment groups (P=0.000). Visual acuity was less than 20/400 in 9 patients (36%) before treatment and 10 patients (45%) at last follow up in group A and in 10 patients (48 %) before and 11 patients (52%) at last follow up in group B. Complications occurred in 15 (60%) and 12 (57%) of patients in group A and B respectively.Conclusion: Both Ru-106 plaque radiotherapy and non-radiation treatments modalities were effective in management of VPTs and tumor regression. There was no statistically differences in visual outcomes