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瑞典人群中的血管性视网膜增殖性肿瘤。

Vasoproliferative retinal tumours in a Swedish population.

机构信息

Department of Ophthalmology, Örebro University Hospital, Sweden.

出版信息

Acta Ophthalmol. 2011 Feb;89(1):91-4. doi: 10.1111/j.1755-3768.2009.01662.x.

Abstract

PURPOSE

To describe the clinical appearance and the visual outcome of a cohort of patients with vasoproliferative retinal tumours (VPRTs) that were diagnosed and treated between 2002 and 2007 at the University Hospital of Örebro.

METHODS

Nine patients with diagnosed VPRTs were included in a retrospective study. The mean age at the time of diagnosis was 50.2 years (range 7-74 years). Follow-up time ranged between 14 and 83 months (mean 42.6). Nine out of ten eyes received cryotherapy; six eyes were also treated with photocoagulation. One patient was treated with intravitreal injections of ranibizumab (Lucentis(®)) and another was referred for brachytherapy. Because of persisting macular oedema, one eye was treated with intravitreal injection of triamcinolon.

RESULTS

Of the treated eyes, one had anterior uveitis, six had macular oedema at baseline and four had an exudative retinal detachment at the time of diagnosis. Seven eyes underwent vitrectomy because of epiretinal membranes. Visual acuity at diagnosis was 0.21 (mean) (range 0.02-0.6) and at latest check-up 0.30 (mean) (range light perception (LP)-1.0), with improvement in six eyes and deterioration in two. Two out of four patients with retinal detachment were successfully treated surgically.

CONCLUSION

VPRTs are benign intraretinal changes. Several complications are associated with this condition. All patients in this study had symptom-giving tumours and six patients (six eyes) already had profound macular oedema at presentation. In these cases, when complications have already developed, the final visual prognosis is poor, thereby making it important to detect these tumours early. The patient who received anti-vascular endothelial growth factor (VEGF; Lucentis) therapy showed a slow improvement and distinct regression in exudations during the follow-up time. However, no increase in visual acuity was seen. At latest examination a peripheral exudative retinal detachment was still observed. Whether anti-VEGF treatment is effective, as either an alternative or complementary therapy, must be established in the future.

摘要

目的

描述一组在 2002 年至 2007 年间于厄勒布鲁大学医院被诊断和治疗的血管性增殖性视网膜肿瘤(VPRT)患者的临床表现和视力结果。

方法

在这项回顾性研究中纳入了 9 名被诊断为 VPRT 的患者。诊断时的平均年龄为 50.2 岁(7-74 岁)。随访时间为 14 至 83 个月(平均 42.6 个月)。10 只眼中有 9 只接受了冷冻疗法;6 只眼还接受了光凝治疗。1 名患者接受了雷珠单抗(Lucentis(®))玻璃体腔内注射治疗,另 1 名患者接受了近距离放射治疗。由于黄斑水肿持续存在,1 只眼接受了曲安奈德玻璃体腔内注射治疗。

结果

在接受治疗的眼中,1 只眼发生了前葡萄膜炎,6 只眼在基线时有黄斑水肿,4 只眼在诊断时发生了渗出性视网膜脱离。由于视网膜内表面膜,7 只眼接受了玻璃体切除术。诊断时的视力平均为 0.21(范围 0.02-0.6),最近一次检查时为 0.30(范围为光感(LP)-1.0),其中 6 只眼视力提高,2 只眼视力下降。4 例视网膜脱离患者中有 2 例手术成功治疗。

结论

VPRT 是良性的视网膜内病变。这种情况会伴有多种并发症。本研究中的所有患者均有症状性肿瘤,6 例(6 只眼)在就诊时已有严重的黄斑水肿。在这些情况下,当已经出现并发症时,最终的视力预后较差,因此早期发现这些肿瘤非常重要。接受抗血管内皮生长因子(VEGF;Lucentis)治疗的患者在随访期间视力缓慢改善,渗出物明显消退。然而,视力并没有提高。在最近的检查中,仍观察到周边渗出性视网膜脱离。抗 VEGF 治疗是否作为一种替代或补充疗法有效,还需要在未来的研究中确定。

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