Vasoproliferative-Like Retinal Tumors Associated With Retinal Vasculitis in Behçet’s Syndrome: Two Case Reports and Literature Review

PURPOSE: To report two cases of vasoproliferative-like retinal tumor (VLRT) associated with Behçet's syndrome (BS), highlighting their contrasting clinical courses and management strategies, supported by multimodal imaging. METHODS: This is a retrospective description of two patients with BS who developed VLRTs. Case 1 involved a 40-year-old woman with a 33-year history of BS, followed for 18 months after VLRT detection. Case 2 involved a 16-year-old boy with a 5-year history of BS, followed for 4 months after incidental VLRT detection. Multimodal imaging included widefield fundus photography, fluorescein angiography, and optical coherence tomography. RESULTS: Case 1 developed an exudative VLRT that responded transiently to three monthly intravitreal bevacizumab injections with adjuvant photocoagulation, but recurred within one month, requiring systemic immunosuppression, a switch to aflibercept, and planned cryotherapy. In contrast, Case 2's lesion remained stable and asymptomatic under adalimumab therapy, with cryotherapy planned due to the lesion's characteristics. CONCLUSION: VLRTs can occur in BS irrespective of prior inflammatory control and may follow variable clinical courses. These cases highlight the importance of widefield imaging surveillance in BS and suggest that optimal management may require individualized combinations of anti-VEGF therapy, ablative procedures, and systemic immunosuppression.