视盘毛细血管瘤激光治疗的疗效观察  

Clinical efficacy of laser therapy to juxtapapillary capillary hemangioma

作　　者：纪海霞[1] 张风[1] 高丽琴[1] 周海英[1] 严伟[1] 焦璇[1] 熊颖[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2015年第6期409-413,共5页Ophthalmology in China

摘　　要：目的探讨激光治疗视盘毛细血管瘤的临床疗效。设计回顾性病例系列。研究对象视盘毛细血管瘤患者11例12眼。方法所有患者接受一种或两种激光的联合治疗,包括传统激光(波长532 nm绿光或波长577 nm黄光)光凝及光动力学疗法(PDT),其中5眼采用传统激光直接光凝瘤体,4眼采用PDT治疗,3眼采用PDT联合传统激光光凝。治疗1~7次,平均(3.3±2.1)次。随访时间2~132个月,平均(42.5±41.8)个月。激光治疗前后检查患者视力,间接检眼镜观察瘤体变化、视网膜下液、出血、前膜等情况。主要指标视力、瘤体大小、视网膜下液、出血、前膜等。结果 11例12眼中,治疗前视力为指数/30cm^1.0,其中视力≥0.5者3眼,<0.5且≥0.1者5眼,<0.1者4眼;治疗后末次随访时视力为眼前手动~1.0,其中视力≥0.5者1眼,<0.5且≥0.1者7眼,<0.1者4眼。治疗后8眼瘤体萎缩机化,1眼瘤体无变化,3眼瘤体继续增长。8眼视网膜下液减少或完全吸收,3眼视网膜下液持续增加;5眼治疗后继发视网膜前膜,4眼继发黄斑区色素沉着。结论适时采取单纯或多种激光联合治疗可有效控制视盘毛细血管瘤的进展。Objective To observe the clinical efficacy of laser therapy to juxtapapillary capillary hemangioma. Design Retrospec- tive case series. Participants 11 patients（ 12 eyes）with juxtapapillary capillary hemangioma were reviewed. Methods All patients were treated with single or combined laser therapy, among which traditional laser therapy （532 nm green laser or 577 nm yellow laser） for 5 eyes, photodynamic therapy （PDT） for 4 eyes, PDT combined with traditional laser therapy for 3 eyes. Treatment times were 1 to 7 times, with a mean of （3.3±2.1） times; The foflow-up period ranged from 2 months to 132 months, with a mean of （42.5±41.8）months. Visual acuity, tumor change, suhretinal fluid, hemorrhage and epiretinal membrane were observed and analysis before and after treat- ment. Main Outcome Measures Vision, tumor change, subretinal fluid, hemorrhage and epiretinal membrane before and after treat- ment. Results The visual acuity before treatment ranged from CF/30 cm to 1.0, in which ≥0.5 in 3 eyes, 〈0.5 and ≥0.1 in 5 eyes, 〈0.1 in 4 eyes. The visual acuity after treatment ranged from hand motion （I4M） to 1.0, in which ≥0.5 in 1 eye, 〈0.5 and ≥0.1 in 7 eyes, 〈 0.1 in 4 eyes. Tumor regressed in 8 eyes, remained no change in 1 eye and became larger in 3 eyes. Subretinal fluid reduced or disap- peared in 8 eyes, enlarged in 3 eyes. 5 eyes developed secondary epiretinal membrane, and 4 eyes developed secondary pigmentation in macula. Conclusion Timely treatment with single or combined laser therapy can help to control tumor growth of juxtapapillary capillary hemangioma in a certain extent.

关 键 词：毛细血管瘤 视盘 激光治疗 Von Hippel—Lindau病 

分 类 号：R739.7[医药卫生—肿瘤]