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[冯·希佩尔-林道综合征病例中的视网膜毛细血管瘤。新的治疗方向]

[Capillary hemangioma of the retina in cases of von Hippel-Lindau syndrome. New therapeutic directions].

作者信息

Bornfeld N, Kreusel K-M

机构信息

Zentrum für Augenheilkunde, Universitätsklinikum Essen, Hufelandstrasse 55, 45122, Essen, Germany.

出版信息

Ophthalmologe. 2007 Feb;104(2):114-8. doi: 10.1007/s00347-007-1485-1.

Abstract

Thermal photocoagulation of small peripheral angiomas is the treatment of choice for capillary hemangiomas in patients with von Hippel-Lindau disease. Larger peripheral angiomas are better treated with beta-ray brachytherapy resulting in improved results in terms of local tumor control and the side effects of treatment. Photodynamic treatment is an alternative option in the management of capillary hemangiomas of the retina. Further improvement of the treatment results of photodynamic therapy may be achieved by combination with intravitreal drugs. External beam radiation using either stereotactic techniques or proton radiation must be considered as experimental. The treatment of juxtapapillary angiomas is still a therapeutic dilemma. Vitreoretinal surgery should be confined to advanced stages with tractional detachment or when no other treatment option is available to salvage the eye.

摘要

对于患有冯·希佩尔-林道病的患者,小的周边血管瘤的热光凝术是治疗毛细血管瘤的首选方法。较大的周边血管瘤采用β射线近距离放射治疗效果更佳,在局部肿瘤控制和治疗副作用方面都能取得更好的结果。光动力治疗是视网膜毛细血管瘤治疗的一种替代选择。通过与玻璃体内药物联合使用,可能会进一步提高光动力疗法的治疗效果。使用立体定向技术或质子辐射的外照射放疗必须被视为实验性治疗。视乳头旁血管瘤的治疗仍然是一个治疗难题。玻璃体视网膜手术应仅限于晚期伴有牵引性视网膜脱离的情况,或在没有其他治疗选择可挽救眼球时使用。

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