Hirakata A, Okada A A, Asakawa M, Mitsui K, Hida T
Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka 181-8611, Japan.
Nippon Ganka Gakkai Zasshi. 2001 Jun;105(6):415-20.
Choroidal hemangioma associated with bullous retinal detachment may be difficult to treat, due to varying results with conventional laser photocoagulation, radiotherapy, or surgical drainage. Here we report on a case of extensive bullous retinal detachment secondary to circumscribed choroidal hemangioma that was resolved after combined treatment with vitrectomy, silicone oil tamponade, and transpupillary thermotherapy.
A 29-year-old woman presented with a large choroidal hemangioma in her right eye associated with serous retinal detachment. The tumor measured 8 disc diameters in size and was located in the inferotemporal macula, abutting the fovea.
Laser photocoagulation of the tumor was unsuccessful in inducing absorption of subretinal fluid. Because of progressive bullous retinal detachment, surgery was performed consisting of external drainage of subretinal fluid, vitrectomy, endolaser photocoagulation of the tumor, and silicone oil tamponade. The silicone oil was removed four weeks postoperatively at which time almost complete resolution of the retinal detachment was observed. However, retinal detachment recurred eight weeks later, and transpupillary thermotherapy was then applied to the tumor. By four weeks after transpupillary thermotherapy, total reabsorption of subretinal fluid, visual acuity improvement, and decreased height of the choroidal hemangioma were noted.
Transpupillary thermotherapy is an effective treatment for serous retinal detachment associated with choroidal hemangioma.
伴有大泡性视网膜脱离的脉络膜血管瘤可能难以治疗，因为传统激光光凝、放射治疗或手术引流的效果各异。在此，我们报告一例继发于局限性脉络膜血管瘤的广泛大泡性视网膜脱离病例，该病例在接受玻璃体切除术、硅油填充和经瞳孔温热疗法联合治疗后得到解决。
一名29岁女性右眼出现一个与浆液性视网膜脱离相关的巨大脉络膜血管瘤。肿瘤大小为8个视盘直径，位于颞下黄斑，靠近中央凹。
对肿瘤进行激光光凝未能促使视网膜下液吸收。由于大泡性视网膜脱离进展，遂进行手术，包括视网膜下液外引流、玻璃体切除术、肿瘤内激光光凝和硅油填充。术后四周取出硅油，此时观察到视网膜脱离几乎完全消退。然而，八周后视网膜脱离复发，随后对肿瘤进行经瞳孔温热疗法。经瞳孔温热疗法四周后，观察到视网膜下液完全吸收、视力改善以及脉络膜血管瘤高度降低。
经瞳孔温热疗法是治疗与脉络膜血管瘤相关的浆液性视网膜脱离的有效方法。
