视盘毛细血管瘤激光治疗的疗效观察

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。

Clinical efficacy of laser therapy to juxtapapillary capillary hemangioma

Objective To observe the clinical efficacy of laser therapy to juxtapapillary capillary hemangioma. Design Retrospective 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 follow-up period ranged from 2 months to 132 months, with a mean of （42.5±41.8）months. Visual acuity, tumor change, subretinal fluid, hemorrhage and epiretinal membrane were observed and analysis before and after treatment. Main Outcome Measures Vision, tumor change, subretinal fluid, hemorrhage and epiretinal membrane before and after treatment. 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 (HM) 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 disappeared 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.