光动力学治疗黄斑部孤立性脉络膜血管瘤  

Photodynamic Therapy for Macular Circumscribed Choroidal Hemangioma

作　　者：张勇进[1] 王文吉[1] 黎蕾[1] 高巧云[1] 沈颖[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国临床医学》2006年第1期136-138,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨和总结光动力学治疗黄斑部脉络膜血管瘤方法和近期效果。方法:经临床、荧光血管造影及B超检查确诊为黄斑部孤立性脉络膜血管瘤并伴有黄斑水肿患者5例,最佳矫正视力0．04-0．5,B超检查最大厚度2．5-3．8mm,最大直径为7．7-9．4 mm,视网膜脱离0．5-4 mm,1例伴有视网膜囊肿。光动力学治疗为静脉注射维速达尔(6 mg／m2体表面积)15min后689nm激光照射,激光参数为50-75 J／cm2,时间为83-125 s,1-2个光斑,随访时间15-28周。结果:治疗后最后随访视力为0．04-1．0,B超检查示2例于治疗后1个月时肿瘤难以测出,3例厚度0．7-3．0mm,最大直径为7．6-8．6 mm,4例视网膜脱离消失,1例视网膜脱离1 mm但视网膜囊肿消失。结论:光动力学治疗孤立性脉络膜血管瘤安全有效,特别对位于黄斑部脉络膜血管瘤,光动力学治疗可使瘤萎缩并保存或提高视力。Objective： To evaluate the efficacy and safety of photodynamic therapy （PDT） in patients of macular choroidal hemangioma. Methods： Five patients, the visual acuity was 0. 04-0.5, were diagnosed as choroidal hemangioma in macular area clinically presenting with serous retina detachment 0. 5 -4mm and with a retinal cyst in 1 case. The hernangioma was 2.5-3. 8mm in thicness and 7. 7-9.4mm in largest dimension measured by B ultrasound. Photodynamic therapy was performed with a concentration of verteporphin 6mg/m^2 body surface area and laser parameter 50-75 J/cm^2 ,83-125s at 689 nm, 2-5.4 mm in size,1-2 spots. All were treated with one session. The follow up time is 15-28 weeks. Results： Visual acuity was 0. 04- 1.0 in last examination. The hemangiorna was undetectable in 2 cases and 0. 7-3.0 mm in thickness and 7.6-8. 6 mm in largest dimension in other 3 cases. Retina detachment was disappeared in all cases but one remain 1mm retinal detachment with the retinal cyst vanished. Conclusion：PDT is effective and safe to reduce the ehoroidal melanoma size , eliminate the subretinal fuild and improve or stable the visual acuity of the patient with tumor under macular area.

关 键 词：脉络膜血管瘤 光动力治疗 荧光血管造影 

分 类 号：R739.7[医药卫生—肿瘤] R454.2[医药卫生—临床医学]