Secondary Retinal Vasoproliferative Tumor in a Patient with Retinitis Pigmentosa: Case Report

Purpose: We report a case of secondary retinal vasoproliferative tumor (RVPT) located at the superonasal retina, accompanied by superior bullous retinoschisis and distant subfoveal serous retinal detachment (SRD) in a patient with retinitis pigmentosa.
Case summary: A 68-year-old female who had retinitis pigmentosa was transferred for subacute onset of visual disturbance in the right eye. The best-corrected visual acuity (BCVA) was hand motion. Cells and flare were 1+ in the anterior chamber and vitreous. An ill-defined peachy gliotic nodule with retinal hemorrhage, 2-3 disc areas in size, was observed at the superonasal retina. Bullous retinoschisis was detected adjacent to the lesion, and distant subfoveal SRD was observed on optical coherence tomography (OCT). Widefield fluorescein angiography (FAG) revealed leakage from rich capillary networks connected to retinal feeder vessels. Leakage from perifoveal retinal vessels and subfoveal choroidal vessels was detected on late-phase FAG and indocyanine green angiography. The orbital magnetic resonance imaging revealed a 4.0 × 2.0 mm mass. The subfoveal SRD was resolved on day 12 after an intravitreal bevacizumab injection, an intravitreal triamcinolone acetonide injection, and cryotherapy. Subfoveal choroidal thickness showed a decrease on OCT from 406 μm at baseline to 153 μm on day 43. Regression of retinoschisis was achieved after additional cryotherapy, an intravitreal bevacizumab injection, and focal laser photocoagulation. The BCVA was restored to 20/50 at postoperative 6 months.
Conclusions: RVPT can cause a combination of chorioretinal pathologies, each of which can be treated with various modalities.