视网膜血管增生性肿瘤的临床特征分析和治疗初探  

Clinical features and preliminary report of treatment of vasoproliferative tumors of the retina

作　　者：张军军[1] 张美霞[1] 唐健[1] 韦纯义[1] 严密[1] 孟丹[1] 黄永志[1] 

机构地区：[1]四川大学华西医院眼科中心,成都610041

出　　处：《中华眼底病杂志》2006年第3期177-180,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的分析视网膜血管增生性肿瘤(VTR)的临床特征,初步探讨其治疗方法。方法回顾性分析经眼底检查、荧光素眼底血管造影(FFA)及B型超声检查确诊的VTR患者17例17只眼的临床资料。其中,1例患者行光动力治疗(PDT),7例患者行视网膜激光光凝治疗。1例患者行玻璃体切割手术时发现VTR予以病理检查和病灶部位激光光凝治疗。结果17例患者17只眼眼底均有单个或多个黄色或红色肿瘤样病变,均同时伴有视网膜内或视网膜下渗出,占100%;伴出血者10只眼,占58.82%;伴视网膜脱离者5只眼,占29.41%。渗出累及黄斑区者9只眼,占52.94%;合并玻璃体积血1只眼,占5.88%。肿瘤位于颞下象限者8只眼,占47.06%;位于颞上象限者7只眼,占41.18%;鼻上下象限各1只眼,分别占5.98%。B型超声检查显示16只眼肿瘤位于视网膜上。FFA检查发现瘤体血管早期即发生明显的荧光素渗漏。1例患者经PDT治疗后肿瘤明显缩小;7例激光光凝的患者中,2例肿瘤缩小,1例渗出减少。结论VTR的临床特征是眼底黄色或红色肿瘤样病变伴视网膜内或视网膜下渗出,B型超声和FFA检查有助于确诊。PDT和激光光凝治疗对控制病变有效,但对视力提高无明显帮助。Objective To observe the clinical features and investigate the method of treatment for vasoproliferative tumors of the retina （VTR）. Methods Retrospectively analyzed the clinical data of 17 VTR patients （17 eyes） who had undergone examination of ocular funds, fundus fluorescein angiography （FFA）, and B ultra-scanning examination, including 1 treated by photodynamic therapy （PDT） and 7 treated by photocoagulation. Pathological examination and photocoagulation was performed on 1 patient who was found with VTR when undergoing vitrectomy. Results Single or multiple red or yellowish tumor lesions were found in ocular fundi of all of the 17 eyes associated with intraretinal and subretinal exudations （100%）, haemorrhages （n=10, 58.82%）, retinal detachment （n=5, 29.41%）, exudative changes at themacula （n=9, 52.94%）, and vitreoushaemorrhage （n=1, 5.88%）. The lesions located at the inferio-temporal quadrant was found in 8 eyes （47.06%）, at the superio-temporal quadrant in 7 （41.18%）, and at the inferio- and superio-nasa[ quadrant in 1 （5.88%）, respectively. The result of B ultra-scanning indicated that 16 patients had the lesions on the retina. The result of FFA demonstrated the leakage of the fluorescein of the tumor at the early stage. The tumor became smaller in size of the patient treated by PDT,and in 7 patients undergone photocoagulation, 2 revealed slightly shrunken lesions and 1 less leakage. Conclusions The clinical features of VTR were red or yellowish tumedity lesions in ocular fundi with intraretinal and subretinal exudations. The examination of B ultra-scanning and FFA may help to diagnose VTR. PDT and photocoaguation are effective on controlling the lesion but are of no avail for the improvement of visual acuity.

关 键 词：视网膜肿瘤/治疗 血管瘤/治疗 

分 类 号：R739.7[医药卫生—肿瘤]