A Rare Association of Reactive Retinal Astrocytic Tumor With Chronic Rhegmatogenous Retinal Detachment

PURPOSE: To report a case of a reactive retinal astrocytic tumor (RRAT) associated with chronic rhegmatogenous retinal detachment (RRD). METHODS: This is a single, retrospective case report. RESULTS: An 82-year-old male presented with a one-year history of gradual blurring of vision in both eyes. Visual acuity was 20/160 in the right eye and hand movements in the left eye. Slit-lamp examination revealed a moderately dense cataract in the right eye and a dense cataract in the left eye complicated by 270° posterior synechiae and a fairly mobile retinal detachment on B-scan ultrasound. The patient underwent combined phacoemulsification without intraocular lens implantation, scleral buckling, and pars plana vitrectomy with silicone oil tamponade in the left eye. Intraoperative findings revealed a total RRD with multiple breaks and a small orange nodular mass incidentally overlying the inferotemporal break. Excisional biopsy confirmed a tumor measuring 0.2 cm in diameter. Histopathological analysis showed glial fibrillary acidic protein (GFAP)-positive glial tissue, numerous cluster of differentiation (CD) 31 (CD31)-positive vascular channels, and moderate CD163-positive macrophage infiltration, consistent with RRAT. The retina remained attached postoperatively, with some improvement in vision. CONCLUSION: This report describes a rare association between occult RRAT and chronic RRD in an elderly patient. Histopathologic examination of such tumors is essential for accurate diagnosis while surgical management must be tailored to tumor size, location, and associated complications.