[Retinal vasoproliferative tumor (retinal reactive astrocytic tumor)]

Retinal vasoproliferative tumor, otherwise known as retinal reactive astrocytic tumor, is a rare entity presenting as a mass in the inferior peripheral retina, associated with vascular abnormalities, and usually accompanied by exudative manifestations that affect the visual prognosis. The precise etiology is unknown, but the predominantly astrocytic and reactive nature of these lesions now appears to be established. It is classified as primary or secondary, and numerous associated ocular conditions have been reported, including pigmentary retinopathy, pars planitis and Coats' disease. The main differential diagnosis is the retinal capillary hemangioblastoma in von Hippel-Lindau disease. There is currently no consensus on the ideal treatment, and numerous therapeutic modalities have been described in limited case series, with variable success rates. Nevertheless, treatment is essential when there is a visual risk and is based on a combined, thoughtful approach to the various therapeutic modalities available, depending on the individual characteristics of the tumor. Conservative treatments such as laser photocoagulation, cryotherapy and/or photodynamic therapy are generally preferred for small tumors, while more invasive treatments such as brachytherapy are proposed for large lesions or tumors for which the exudative activity cannot be controlled. Vitreoretinal surgery is frequently required for complications such as retinal detachment, epiretinal membranes or vitreous hemorrhage. Intravitreal anti-VEGF injections are an adjuvant treatment for the macular edema frequently associated with the disease.