孤立性脉络膜血管瘤的光动力疗法治疗观察  

Photodynamic therapy for circumscribed choroidal hemangioma

作　　者：张勇进[1] 王文吉[1] 徐格致[1] 钱江[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：《中华眼底病杂志》2007年第1期21-23,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察光动力疗法（PDT）治疗孤立性脉络膜血管瘤的临床效果。方法回顾分析采用PDT连续治疗的14例孤立性脉络膜血管瘤患者的临床资料。14例患者均经过临床常规眼科检查和荧光素眼底血管造影以及B型超声等检查确诊。治疗前最佳矫正视力0．01～0．8；B型超声检查肿瘤直径为7．2～9．8mm，最大直径平均为（8．4±0．8）mm，厚度为1．7～4．9mm，最大厚度平均为（3．5±0．9）mm。8例患者同时合并有视网膜脱离，其高度为0．5～4．0mm，1例伴有视网膜囊肿。PDT治疗时静脉注射维替泊芬，剂量为6mg／m^2，10min内注射完毕。5min后应用689nm波长激光进行照射，激光参数为50～75J／cm^2，时间83～125s，1～4个光斑。治疗后随访时间为3～24个月，平均随访时间为9．1个月。结果最后随访时视力为0．04～1．0。其中，8例视力提高2行以上，6例视力稳定（变化不超过2行）。B型超声检查，4例患者肿瘤难以测出；其他10例患者肿瘤直径O～8．0mm，最大直径平均为（5.0±3．4）mm，肿瘤厚度为0～3．5mm，最大厚度平均为（1．6±1．3）mm。7例患者视网膜脱离消失，1例视网膜仍脱离1mm但视网膜囊肿消失。结论PDT治疗可使脉络膜血管瘤肿瘤萎缩，视网膜下液消失，视网膜复位，达到提高或保存视力的目的；是治疗包括位于黄斑部的孤立性脉络膜血管瘤的安全有效方法。Objective To assess the clinical effect of photodynamic therapy （PDT） on patients with circumscribed choroidal hemangioma. Methods The clinical data of 14 patients with circumscribed choroidal hemangioma, which had been diagnosed by clinical general examination, fundus fluorescein angiography, and B-scanning ultrasound examination were retrospectively analyzed. All of the patients had undergone PDT Photodynamic therapy. The best corrected visual acuity before PDT was 0.01-0.8; the diameter of the tumor was 7.2-9.8 mm [with the mean of the largest diameter of （8.4±0.8） mm], and the thickness was 1.7-4.9 mm[with the mean of the largest thickness of （3.5±0.9） mm]. Eight patients suffered from retinal detachment simultaneously with the height of 0.5-4 mm, and 1 had retinal cyst. The intravenous injection with visudyne （6 mg/m^2） was performed in 10 minutes, and 5 minutes later, laser irradiation with the wavelength of 689 nm was performed with the parameters of 50-75 J/cm^2, 83-125 seconds, and 1-4 spots. The follow-up period was 3-24 （mean 9.1 months）months. Results The visual acuity in the last examination after treatment was 0.04-1.2, which was 2-line increased in 8 patients and was steady in 6 （changed within 2 lines）. The result of B-scanning ultrasound examination showed that the hemangioma was undetectable in 4 patients, and in the other 14, the hemanigioma had the diameter of 0-8.0 mm [with the mean of the largest diameter of （5.0±3.4） mm] and the thickness of 0（3.5 mm [with the mean of the largest diameter of （1.6±1.3） mm]. Retinal detachment disappeared in 7 patients while the other 1 still had with the height of 1 mm and without the retinal cyst. Conclusion PDT may lead to the shrinking of choroidal hemangioma, disappearance of subretinal liquid, reattachment of retina, and increasing and saving the visual acuity. It is the effective and safe treatment for macular circumscribed choroidal hemangioma.

关 键 词：脉络膜肿瘤/治疗 血管瘤/治疗 光化学疗法/方法 激光疗法 小剂量 治疗结果 

分 类 号：R686[医药卫生—骨科学]