早期非典型性视网膜星形细胞错构瘤的多模式影像学特征

目的 探讨早期非典型性视网膜星形细胞错构瘤影像学特征.方法 收集2019年3月至2020年10月就诊于河北省眼科医院临床诊断为早期非典型性视网膜星形细胞错构瘤的患者8例8眼,对所有患者进行常规眼科检查以及彩色眼底照相、红外眼底照相、荧光素眼底血管造影(FFA)或吲哚菁绿血管造影(ICGA)、OCT、OCTA检查.同时给...

Multimodal imaging characteristics of early atypical retinal astrocytic hamartoma

Objective　To investigate the imaging characteristics of early atypical retinal astrocytic hamartoma (RAH).Methods　Together 8 patients (8 eyes) who visited Hebei Eye Hospital during March 2019 to October 2020 with clinical diagnosis of early atypical RAH were included in this study. All patients underwent routine ophthalmic examinations, color fundus photography, infrared fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) during and 3-6 months accompanied with drug therapy, the changes of OCT, OCTA and FFA in different periods were recorded. Then the clinical features of patients in different periods were summarized and analyzed.Results　The head CT and skin examination results of all patients were normal, and no calcification was found in the fundus masses through B-ultrasonography. The lesion of all the 8 patients (8 eyes) with early atypical RAH occurred singly, located at the peripapillary region and posterior pole. Color fundus photography and infrared fundus photography showed that the tumors were oval, nodular, irregular, translucent and flat bulges in 6 eyes, and the retinal vessels were observed. The tumors were flat bulges in 2 eyes with no exudation or edema. FFA showed that the capillaries on the surface of tumor represented clustered dilation with weak fluorescence in 6 eyes, and the capillaries were located under the retinal vessels. The lesion of 1 eye showed strong fluorescence leakage in the late stage of FFA, while 1 eye showed strong fluorescence in the late stage of FFA with no leakage. ICGA were normal in the choroidal vessels corresponding to the tumor body. OCT showed inhomogeneous thickening and disorder of the inner retinal layer in all 8 eyes. The moth-eaten lesion with low reflex areas was demonstrated in 5 eyes. The other 3 eyes showed localized thickening of the retinal nerve fiber layer with low reflex areas. OCTA represented clump-like dilated blood vessels in the early lesions of all the 8 eyes, a large number of capillary networks were observed on the superficial capillary layer of the tumor, and messy vessels were observed in the deep capillary layer of the tumor with irregular low reflection. OCTA was used to follow up and re-scan the same site of the tumor, and it was found that as conditions improved, the tumor body became little, and the angiectasis gradually decreased, and finally the retina returned to normal.Conclusion　Multimodal imaging is helpful for the diagnosis of early atypical RAH. No special treatment needs for the disease. The tumor can fade away on its own, and the edema and exudation may absorb on its own, but regular fundus examinations, OCT and OCTA should be taken before the complete calcification of the tumor mass.