Solitary Circumscribed “Pearl White” Retinal Mass (So-Called Retinal Astrocytic Proliferation) Resides in Deep Retina or Beneath Retina: Findings on Multimodal Imaging in 4 Cases

Shields, Carol L.; Roe, Richard H.; Yannuzzi, Lawrence A.; Shields, Jerry A.

doi:10.1097/icb.0000000000000278

Cited by 15 publications

(21 citation statements)

References 11 publications

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“…This case was described as the spontaneous disappearance of hyperplasia of astrocytes, before the use of the term presumed circumscribed solitary proliferation of retinal astrocytes 3,4. Shields et al5 consider that the PSCRAP derived from the RPE or deep retina and not in the inner layers as they thought in the first description 3,5. Goldberg and Raja6 also consider that the lesion arises from the deep retina or RPE, whereas with OCT angiography characteristics of the lesion show a lack of intrinsic or paralesional vascular flow, indicating that this lesion is fibrous and likely derived from the RPE or deep retina and not the retinal astrocytes 6.…”

Section: Discussionmentioning

confidence: 99%

<p>Presumed solitary circumscribed retinal astrocytic proliferation: a lesion that can regress</p>

Asensio-Sánchez¹

2019

IMCRJ

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A 56-year-old woman had an yellow-white retinal lesion superior to the optic disc. Optical coherence tomography demonstrated the mass with a snowball configuration and smooth surface. Autofluorescence disclosed revealed moderate hypoautofluorescence. Ultrasonography showed no calcification. Visual field examination showed an enlargement of the blind spot corresponding to the predominantly superotemporal juxtapapillary extension of the lesion. Eight months later, the lesion spontaneously resolved. Presumed solitary circumscribed retinal astrocytic proliferation (PSCRAP) is a benign stable retinal tumor, but PSCRAP has been reported to resolve spontaneously here. It differs from other white or yellow-white lesions of the retina in important ways that enable the ophthalmologist to reassure the patient as to its benign prognosis.

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Section: Discussionmentioning

confidence: 99%

<p>Presumed solitary circumscribed retinal astrocytic proliferation: a lesion that can regress</p>

Asensio-Sánchez¹

2019

IMCRJ

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“…9 Aynı şekilde, Shields ve ark.nın 2016 yılında yaptığı ve 2011 yılındaki çalışmanın devamı niteliğinde olan araştırmada RAP'nin retinanın dış katlarından kaynaklandığı SD-OKT ile gösterilmiş ve OKT'nin ayırıcı tanısında diğer klinik bulgulardan bir adım öne çıktığı vurgulanmıştır. 10 Olgumuzda, SD-OKT ile yapılan değerlendirmeler sonrasında lezyonun RSLT tabakasından kaynaklandığı görülmüş ve RAH tanısı koyulmuştur.…”

Section: Olgu Sunumuunclassified

“…2 Oküler ultrasonografi (USG)'nin retinal astrositik lezyonların tanı ve ayırıcı tanısında önemli bir yeri olmakla beraber, USG kalsifikasyon içermeyen Tip 1 ve Tip 2 RAH hastalarının saptanmasında yetersiz olmaktadır. 5,10,11 FA, FOF ve İSYA lezyonları tanımlamada ve ayırıcı tanıda yardımcı olabilecek diğer testlerdir. 3,4,12 FA'da retinal glial proliferatif hastalıklar (RAP, RAH, edinsel retinal astrositoma ve reaktif gliozis) lezyonları besleyen damarlardaki düzensizliğe bağlı olarak geç dönemde hiperfloresandır- lar.…”

Section: Olgu Sunumuunclassified

An Isolated Retinal Astrocytic Hamartoma

Yılmaz¹,

Küçükevcilioğlu²,

Durukan³

et al. 2019

Turkiye Klinikleri J Ophthalmol

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“…19 This solitary retinal mass usually demonstrates a striking yellow-white ''pearl-like,'' circumscribed and abruptly elevated mass on the inner retinal surface (Figure 3). 19,20 Occasionally there are surrounding localized RPE alterations. 20 There is no relationship with TSC.…”

Section: Clinical Features Of Scrapmentioning

confidence: 99%

The American Society of Retina Specialists 2016 Founders Award Lecture

Shields

2017

Journal of VitreoRetinal Diseases

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Purpose: To review the current state of the art of retinal tumors with respect to clinical features, imaging, and management. Methods: Review of published literature and personal experience from an ocular oncology service. Results: There are several tumors that arise from the sensory retina including those of glial origin (astrocytic hamartoma, acquired astrocytoma, and solitary circumscribed retinal astrocytic proliferation), neural origin (retinoblastoma), and vascular origin (hemangioblastoma, cavernous hemangioma, racemose hemangioma, and vasoproliferative tumor). Most retinal tumors are benign with the exception of retinoblastoma and retinal metastasis. Some retinal tumors are associated with systemic oculoneurocutaneous syndromes such as tuberous sclerosis complex (TSC), 13q deletion syndrome, Von Hippel-Lindau disease, and systemic cavernous and racemose hemangioma syndromes with ocular, cutaneous, neurologic, and other findings. Regarding management, recent data indicate that retinal astrocytic hamartoma and retinal achromic patch are key to the diagnosis of TSC and imply greater risk for brain and kidney tumors. Some children with TSC respond to mammalian target of rapamycin inhibitors, controlling brain, kidney, and eye tumors. Children with retinoblastoma are all screened genetically, and systemic evaluation is provided for detection of metastasis and secondary-related tumors. Newer chemotherapy regimens by intravenous or intra-arterial routes have revolutionized retinoblastoma control. Retinal vascular tumors are uncommon but can have serious systemic implications. Therefore, imaging of the brain for related cerebellar hemangioblastoma, midbrain racemose hemangioma, or multifocal cavernomas is performed. Genetic testing for each disease can be revealing. Conclusions: Retinal tumors are often benign, can be recognized by clinical and imaging features, and can be associated with important systemic syndromes.

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Solitary Circumscribed “Pearl White” Retinal Mass (So-Called Retinal Astrocytic Proliferation) Resides in Deep Retina or Beneath Retina: Findings on Multimodal Imaging in 4 Cases

Cited by 15 publications

References 11 publications

<p>Presumed solitary circumscribed retinal astrocytic proliferation: a lesion that can regress</p>

<p>Presumed solitary circumscribed retinal astrocytic proliferation: a lesion that can regress</p>

An Isolated Retinal Astrocytic Hamartoma

The American Society of Retina Specialists 2016 Founders Award Lecture

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