Abstract
INTRODUCTION: To assess the outcomes of pars plana vitrectomy (PPV) in patients with complications related to retinal focal nodular gliosis (FNGs), also known as vasoproliferative tumours. MATERIAL/SUBJECTS AND METHODS: This retrospective case series included 22 patients who underwent PPV for the management of FNG-related complications at Moorfields Eye Hospital between 2012 and 2024. We collected and analysed the patient demographics, clinical features and surgical outcomes. RESULTS: The mean age was 50.59 years (SD 14.5) at presentation and 52.59 years (SD 13.9) at the time of surgery. The most common indications for surgery were epiretinal membrane (n = 9, 40.9%) and vitreous haemorrhage (n = 8, 36.4%). Fifteen eyes (68.2%) were treatment-naïve, while five (22.7%) had previously undergone ruthenium plaque radiotherapy. The median follow-up period was 34 months (IQR 6.0-62.2). The median preoperative visual acuity was 1.15 logMAR (IQR 0.67-2.40), which significantly improved to 0.4 logMAR (IQR 0.17-1.0) at the last follow-up visit (p < 0.01). Postoperative complications were not observed in 14 patients (63.6%), while cystoid macular oedema was the most common complication following vitrectomy (13.6%, n = 3). Three patients required FNG-related re-operation for rhegmatogenous retinal detachment, macular hole, and epiretinal membrane. All FNGs were inactive at the last follow-up visit. DISCUSSION: Vitreous haemorrhage and epiretinal membrane are the most common indications for surgery in patients with FNG. PPV demonstrates favourable functional and anatomic outcomes, though it is worth noting a 13.6% re-operation rate for complications. Significant visual improvement and effective tumour control are also recorded in the long-term.