Hemorrhagic giant retinal cyst: a rare complication of a retinal vasoproliferative tumor

To present a rare case of a giant cyst with intralesional hemorrhage associated with a peripheral retinal vasoproliferative tumor (RVPT).

A 57-year-old male with vision loss in the right eye had an epiretinal membrane. Surgery revealed a yellowish-red mass with a large cyst in the retina, which was diagnosed as a peripheral RVPT. The lesion was observed until intralesional hemorrhage and progressive growth developed.

Intravitreal anti-VEGF injection reduced intralesional bleeding, and external cryotherapy achieved regression and stability of both the tumor and the cyst.

The differential diagnoses for this entity primarily included other retinal tumors and pars plana cysts. We suspected that this rare presentation of RVPT associated with a giant cyst might be due to contraction of the glial tissue. Intralesional hemorrhage resulting from vascular penetration inside the cyst was resolved with intravitreal anti-VEGF treatment, resulting in intrinsic vascular regression.

Giant haemorrhagic retinal cysts are a rare, previously undescribed complication of peripheral retinal vasoproliferative tumours, in which anti-VEGF therapy may reduce bleeding.