Efficacy of Retinal Lesion Screening in Von Hippel-Lindau Patients With Widefield Color Fundus Imaging Versus Widefield FA

Abstract

BACKGROUND AND OBJECTIVE: Retinal hemangioblastoma is a retinal tumor in patients with Von Hippel-Lindau (VHL). The authors' objective was to determine whether widefield fluorescein angiography (FA) improves lesion detection. PATIENTS AND METHODS: Retrospective case series of VHL patients who underwent widefield fundus imaging and FA. Masked retina specialists graded fundus images as having: 1) definite retinal hemangioblastoma; 2) possible lesion; 3) no lesion. The number of lesions on FA was compared to widefield color imaging. RESULTS: One hundred six eyes of 55 patients were evaluated. A total of 94 lesions were identified on FA in 61.8% patients. Forty-three lesions (45.7%) were not identified on fundus images. Small lesion detection was significantly higher with FA compared to color imaging ( P = .013). CONCLUSIONS: This study reports on improved detection of retinal hemangioblastomas with widefield FA compared to widefield fundus images. The authors recommend VHL monitoring guidelines to include periodic widefield FA to adequately screen for smaller lesions. [ Ophthalmic Surg Lasers Imaging Retina. 2019;50:e260–e265.]

A pilot trial of intravital microscopy in the study of the tumor vasculature of patients with peritoneal carcinomatosis

“…In this pilot study, we showed for the first time, that HIVM observations were feasible for patients with PC during the course of CRS-HIPEC. To date, there are a small number of reports demonstrating successful IVM techniques in the study of human cancers outside of hollow organs (GI tract, bladder) 10 , 22 , 23 . Similar to our previous study of HIVM observations of melanoma-associated vessels where up to 50% of vessels were non-functional 10 , PC-associated vessels also had a high rate of non-functionality (mean percentage of non-functional tumor vessels = 46.0%).…”

Belzutifan-induced regression of retinal capillary hemangioblastoma: A case-series

“… 11 A recent study has demonstrated that ultra-widefield FA may detect peripheral RH better than conventional ophthalmoscopy or angiography. 12 , 13 , 14 Several treatment modalities have been attempted to manage RHs including observation, argon laser photocoagulation, cryotherapy, radiotherapy, and ablation during surgery. 4 , 5 Belzutifan is a novel hypoxia-inducible factor 2-alpha inhibitor recently approved for managing patients with VHL who have associated RCC, central nervous system hemangioblastomas, or pancreatic endocrine tumors.…”

Imaging features of retinal hemangioblastoma: A case report

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