视盘黑色素细胞瘤病例报道1例并文献回顾  

A case report of melanocytoma of optic disc and literature review

作　　者：冯晶华 杨潮 李钠 吴小艳 武燕 杨迎新[2] FENG Jinghua;YANG Chao;LI Na;WU Xiaoyan;WU Yan;YANG Yingxin(Beijing University of Chinese Medicine,Beijing100029,China;Department of Ophthalmology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing100010,China)

机构地区：[1]北京中医药大学,北京100029 [2]首都医科大学附属北京中医医院眼科,北京100010

出　　处：《中国医药导报》2024年第8期192-195,共4页China Medical Herald

基　　金：国家重点研发计划项目(2022YFC3502504);国家自然科学基金资助项目(81873344);国家自然科学基金青年科学基金资助项目(82004424)。

摘　　要：视盘黑色素细胞瘤(MCOD)是临床罕见的疾病,容易和脉络膜黑色素瘤相混淆,两者治疗方式截然不同,MCOD为良性疾病,存在恶性转化可能,因此与恶性疾病进行鉴别,及时发现肿瘤恶性转化对后续治疗至关重要。本文报道1例体积较大的右眼MCOD,最佳矫正视力为20/20,眼底照相可见右眼视盘区近似椭圆形的黑色肿物,边界不清,呈羽毛状;眼部B型超声可见右眼视盘上圆顶状隆起占位病灶;视野弓形缺损;光学相干断层扫描成像提示右眼神经节细胞层变薄;光学相干断层扫描血管成像提示右眼血流密度增高,脉络膜血流缺损。诊断考虑为MCOD,未进行干预治疗,观察随访4个月后,瘤体无明显变化,嘱患者每年定期复查。分析检查结果发现:弓形视野缺损区域与患眼神经节细胞变薄区域有一致性,与脉络膜血流缺损、视网膜黄斑区血管密度增高具有相关性。通过对此病历进行总结归纳,并回顾文献研究,为临床医生提供诊断依据。Melanocytoma of optic disc(MCOD)is a rare clinical disease,which is easily confused with choroidal melanoma,and the treatment methods of the two are completely different.MCOD is a benign disease with the possibility of malignant transformation,so it is very important to distinguish it from malignant diseases and find malignant transformation of tumors in time for follow-up treatment.This paper reported a large case of MCOD in the right eye,with a best corrected visual acuity of 20/20,and an oval-shaped black mass with unclear borders and feathery appearance in the optic disc area of the right eye on fundus photography.Ocular type B-ultrasonic showed a dome-shaped bulge mass lesion on the optic disc of the right eye;arcuate defect of visual field;optical coherence tomography showed thinning of the ganglion cell layer in the right eye.Optical coherence tomography angiography showed increased blood flow density in the right eye and choroidal blood flow defects.The diagnosis was considered to be MCOD,and no intervention treatment is carried out,and after four months of observation and follow-up,the patient’s tumor have no obvious change,and the patient is asked to recheck regularly every year.The results of analysis and examination showed that the area of arcuate visual field defect was consistent with the thinning area of ganglion cells in the affected eye,and was correlated with choroidal blood flow defect and increased vascular density in retinal macular area.By summarizing the medical records and reviewing the literature research,the diagnosis basis was provided for clinical doctors.

关 键 词：视盘黑色素细胞瘤 光学相干断层扫描血管成像 视野缺损 血管密度 神经节细胞 

分 类 号：R739.4[医药卫生—肿瘤]