Tuberous sclerosis presenting as atypical aggressive retinal astrocytoma with proliferative retinopathy and vitreous haemorrhage


Pui Ling TANG  and Mae-Lynn Catherine BASTION 

Department of Ophthalmology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Malaysia



A young lady with background features of tuberous sclerosis presented with sudden onset of floaters in the left eye. Initial visual acuity was 6/6 OU. Fundus examination showed an aggressive retinal astrocytoma with proliferative retinopathy and vitreous haemorrhage. Fundus fluorescein angiogram confirmed the presence of new vessels on the optic discs and on the astrocytoma. The patient received sectoral argon laser photocoagulation to the left eye. The vitreous haemorrhage and proliferative retinopathy subsequently subsided. The right eye remained quiescent throughout. The patient presented with a second episode of the left eye dense vitreous haemorrhage, with visual acuity of finger counting; necessitated a trans pars plana vitrectomy and vitreous clearance. Post vitrectomy, fundus showed telangiectatic vessels temporal to optic disc and inferotemporal arcades, with cystoids macular oedema. The patient received top up of pan retinal photocoagulation. Left BCVA remained 6/36, N18 after a decade of follow up.


Keywords: Aggressive retinal astrocytoma, proliferative retinopathy, tuberous sclerosis


Correspondence author: TANG Pui Ling. Department of Ophthalmology, Level 9, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaakob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia.

Tel: +0060126300236, +0060391455982. E mail:

Brunei Int Med J. 2015; 11 (1): 49-53

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