Sagong Min, Lee Junyeop, Chang Woohyok
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.
Korean J Ophthalmol. 2009 Jun;23(2):127-31. doi: 10.3341/kjo.2009.23.2.127. Epub 2009 Jun 9.
We report 3 cases of circumscribed choroidal hemangioma (CCH) effectively managed with intravitreal bevacizumab. One patient (case 1) who had recurrent CCH (1.6 mm in thickness) with prior laser photocoagulation was treated with intravitreal bevacizumab alone. Two patients (case 2 and 3) who had CCH (2.4 mm and 2.2 mm in thickness, respectively) with recent visual impairment were treated with bevacizumab followed by photodynamic therapy (PDT). Ophthalmic evaluations included visual acuity, ophthalmoscopic examination, fluorescein angiography, ultrasonography, and optical coherence tomography. Patients were followed up for 6-9 months. After therapy, all patients showed improved visual acuity due to complete resorption of subretinal fluid and macular edema. Ultrasonography demonstrated a reduction of the thickness of CCH in case 1 and complete regression of the lesions in case 2 and 3. No patient showed tumor recurrence. Intravitreal bevacizumab, alone or in combination therapy with PDT, may be a useful alternative for the treatment of symptomatic CCH with subretinal fluid.
我们报告了3例采用玻璃体内注射贝伐单抗有效治疗的局限性脉络膜血管瘤（CCH）。1例患者（病例1）曾接受激光光凝治疗，现复发CCH（厚度为1.6mm），仅接受了玻璃体内注射贝伐单抗治疗。另外2例患者（病例2和病例3）近期出现视力损害，分别患有厚度为2.4mm和2.2mm的CCH，先接受了贝伐单抗治疗，随后进行了光动力疗法（PDT）。眼科评估包括视力、检眼镜检查、荧光素血管造影、超声检查和光学相干断层扫描。对患者进行了6至9个月的随访。治疗后，由于视网膜下液和黄斑水肿完全吸收，所有患者的视力均有所改善。超声检查显示病例1中CCH的厚度减小，病例2和病例3中的病变完全消退。没有患者出现肿瘤复发。玻璃体内注射贝伐单抗单独使用或与PDT联合治疗，可能是治疗伴有视网膜下液的有症状CCH的一种有效替代方法。
