Open AccessRetinal astrocytoma with exudative retinal detachment treated with photodynamic therapy in a young girl with tuberous sclerosis
Author(s) -
Wei-Yi Chou,
Fenq-Lih Lee
Publication year - 2021
Publication title -
taiwan journal of ophthalmology
Language(s) - English
Resource type - Journals
eISSN - 2211-5072
pISSN - 2211-5056
DOI - 10.4103/tjo.tjo_15_20
Subject(s) - medicine , tuberous sclerosis , ophthalmology , fundus (uterus) , retinal , retinal detachment , visual acuity , lesion , verteporfin , retina , photodynamic therapy , coats' disease , pathology , choroidal neovascularization , chemistry , physics , organic chemistry , optics
Around 50% of patients with tuberous sclerosis have the manifestation of retinal astrocytomas. Symptomatic retinal astrocytomas are very rare, with no consensus on optimal treatment. A 7-year-old patient with tuberous sclerosis presented with progressive blurred vision in the right eye for more than half a year. On examination, best-corrected visual acuity was 20/30 in the right eye and 20/20 in the left eye. Dilated fundus examination of the right eye showed a well-circumscribed, elevated, opaque lesion, with surrounding lipid exudate, and retinal detachment involving the fovea. Spectral-domain optical coherence tomography of the right eye revealed an intraretinal lesion with adjacent subretinal fluid. A diagnosis of retinal astrocytoma with exudative retinal detachment was made. The patient was treated with verteporfin photodynamic therapy (PDT) on the lesion in the right eye. After 1 month, complete resolution of subretinal fluid was observed. At 21-month follow-up, the right eye vision was stable at 20/20, without ocular or systemic adverse events. In conclusion, PDT had a good safety profile in a cooperative pediatric patient, and was able to induce regression of astrocytoma as well as resolution of exudation with excellent visual outcome.