光动力疗法治疗孤立性脉络膜血管瘤临床疗效观察

目的 评价光动力疗法(PDT)治疗孤立性脉络膜血管瘤的临床效果.方法 经眼底检查、荧光素眼底血管造影、B超及OCT检查确诊的孤立性脉络膜血管瘤患者21例21只眼,伴有不同程度渗出性视网膜脱离和黄斑水肿.患者术前最佳矫正视力为HM/眼前～0.8,B超检查瘤体最大直径6.7～15.6mm(平均8.9mm).光敏剂为维替泊芬,激光波长689nm,功率密度600mW/cm2,曝光时间166s.结果 所有患者经1～2次(平均1.3)光动力治疗,光斑直径4200～7500μm,1～5个光斑(平均1.5个).随访6～73个月,最佳矫正视力提高者7只眼(33.3%),视力稳定者14只眼(66.7%),无视力明显下降病例.B超检查显示瘤体变小甚至萎缩,FFA、OCT显示渗出性视网膜脱离及黄斑水肿吸收.结论 光动力疗法治疗孤立性脉络膜血管瘤安全有效,可使瘤体萎缩,视网膜内积液及视网膜下液吸收,保存或提高患者视力.

Clinical observation of photodynamic therapy for the treatment of circumscribed choroidal haemangioma in Chinese patients

Objective To assess the efficacy and safety of photodynamic therapy (PDT) for the treatment of circumscribed choroidal haemangioma (CCH) in Chinese patients. Methods Of 21 patients (21eyes))with CCH were treated with PDT (visudyne 6 mg/m2 body surface area and a light dose of 100 J/cm2) at 689 nm diode laser applied over 166 seconds per spot. Overlapping multiple spots were applied to cover the entire tumor surface. The best-corrected visual acuity on baseline was ranged from HM to 0.8 and pretreatment tumor diameter was 6.7～15.6mm (mean 8.9mm)). Periodic follow-up with ophthalmoscopy, ultrasonography B scan,optical coherence tomography (OCT) and angiographic studies were performed. Results All patients underwent 1 or 2 (mean 1.3) times PDT treatment with 1～5 (mean 1.5) spots in diameter of4200～7500μm. Visual acuity improved in seven of 21 eyes (33.3%), remained stable in 14 eyes (66.7%) during 6～73 months'follow-up (mean 28 months). No case with markedly decreased visual acuity was observed. The tumors were markedly regressed in ultrasonography B scan, OCT and fundus fluorescein angiography (FFA) showed residual leakage were obviously resolved with the overlying retinal vessels remained unaffected. There was no ocular or systemic complication. Conclusion PDT is a safe and effective treaunent modality for circumscribed choroidal haemangioma. It may regress the tumor, restore or improve the visual acuity without causing significant ocular or systemic side-effects.