Vishnevskia-Dai Vicktoria, Goldberg Hila, Ostrovsky Michael, Zloto Ofira, Shemesh Rachel
Faculty of Medical and Health Sciences, Tel Aviv University, Israel.
Ocular Oncology, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Heliyon. 2024 Nov 21;11(1):e40533. doi: 10.1016/j.heliyon.2024.e40533. eCollection 2025 Jan 15.
Pigmentary posterior vitreous detachment (PVD), referred to as "black PVD," is a rare entity describing PVD along with pigment dispersion in the vitreous. There are a few case reports describing pigmentary PVD, yet the association between pigmentary PVD and uveal and optic disc tumors was not described before. The aim of this study was to report the clinical features of patients with pigmentary PVD associated with these tumors.
An 8-year retrospective cohort study.
Eight patients who were diagnosed with pigmentary PVD associated with a uveal tumor or optic nerve pigmented tumors in a tertiary medical center.
Demographics, clinical data, type of uveal lesion, treatment, multimodal images, and follow-up information were retrieved.The main outcome measures were tumor recurrence, vitreous spread, and the patient's prognosis.
Most patients were female (5/8; 62.5 %), with a mean age of 55.8 ± 4.41 years. The right eye was more frequently involved (5/8; 62.5 %). The most prevalently associated ocular tumor was malignant choroidal melanoma (7/8; 87.5 %). A pigmentary PVD was observed on presentation in one case (1/8; 12.5 %); the remaining cases had pigmentary PVD documented during follow-up. VA was significantly worse at the end of follow-up, with a mean of 0.10 ± 0.14 logMAR at the first appointment and 1.20 ± 0.37 logMAR at the last appointment (p = 0.0101). The IOP remained stable, with a mean of 13.5 ± 0.63 mmHg at the first appointment and 14.5 ± 0.50 mmHg at the last appointment (p = 0.2328). The median follow-up duration was 63.5 months. Patients presented with a mean initial lesion thickness of 4.8 ± 1.01 mm, which remained stable throughout the follow-up with a mean thickness of 3.2 ± 0.71 (p = 0.2173). None of the cases exhibited recurrence, vitreous spread, or growth of the ocular lesion during follow-up.
A pigmentary form of PVD may accompany both benign and malignant pigmented uveal tumors, affecting a wide range of patients. The dispersion of pigment from the tumor collars the vitreous in black, yet the black PVD does not necessarily indicate tumor recurrence or vitreous spread.
色素性玻璃体后脱离（PVD），即“黑色PVD”，是一种罕见的情况，指的是PVD伴有玻璃体中的色素分散。有一些病例报告描述了色素性PVD，但此前未描述色素性PVD与葡萄膜及视盘肿瘤之间的关联。本研究的目的是报告伴有这些肿瘤的色素性PVD患者的临床特征。
一项8年的回顾性队列研究。
在一家三级医疗中心被诊断为伴有葡萄膜肿瘤或视神经色素性肿瘤的色素性PVD的8例患者。
检索人口统计学资料、临床数据、葡萄膜病变类型、治疗方法、多模态影像以及随访信息。主要观察指标为肿瘤复发、玻璃体播散及患者预后。
大多数患者为女性（5/8；62.5%），平均年龄55.8±4.41岁。右眼受累更常见（5/8；62.5%）。最常伴发的眼部肿瘤是脉络膜恶性黑色素瘤（7/8；87.5%）。1例患者在初诊时发现色素性PVD（1/8；12.5%）；其余病例在随访期间记录到色素性PVD。随访结束时视力显著变差，初诊时平均logMAR视力为0.10±0.14，末次随访时为1.20±0.37（p = 0.0101）。眼压保持稳定，初诊时平均为13.5±0.63 mmHg，末次随访时为14.5±0.50 mmHg（p = 0.2328）。中位随访时间为63.5个月。患者初诊时病变平均厚度为4.8±1.01 mm，随访期间保持稳定，平均厚度为3.2±0.71（p = 0.2173）。随访期间所有病例均未出现肿瘤复发、玻璃体播散或眼部病变生长。
色素性PVD可能伴随良性和恶性色素性葡萄膜肿瘤出现，影响广泛的患者群体。肿瘤色素的分散使玻璃体呈黑色，但黑色PVD不一定表明肿瘤复发或玻璃体播散。
