Ocular Oncology Unit, Royal Liverpool University Hospital, Liverpool, UK.
Eye (Lond). 2013 Feb;27(2):208-16. doi: 10.1038/eye.2012.251. Epub 2012 Nov 30.
The most common intraocular vascular tumours are choroidal haemangiomas, vasoproliferative tumours, and retinal haemangioblastomas. Rarer conditions include cavernous retinal angioma and arteriovenous malformations. Options for ablating the tumour include photodynamic therapy, argon laser photocoagulation, trans-scleral diathermy, cryotherapy, anti-angiogenic agents, plaque radiotherapy, and proton beam radiotherapy. Secondary effects are common and include retinal exudates, macular oedema, epiretinal membranes, retinal fibrosis, as well as serous and tractional retinal detachment, which are treated using standard methods (ie, intravitreal anti-angiogenic agents or steroids as well as vitreoretinal procedures, such as epiretinal membrane peeling and release of retinal traction). The detection, diagnosis, and monitoring of vascular tumours and their complications have improved considerably thanks to advances in imaging. These include spectral domain and enhanced depth imaging optical coherence tomography (SD-OCT and EDI-OCT, respectively), wide-angle photography and angiography as well as wide-angle fundus autofluorescence. Such novel imaging has provided new diagnostic clues and has profoundly influenced therapeutic strategies so that vascular tumours and secondary effects are now treated concurrently instead of sequentially, enhancing any opportunities for conserving vision and the eye. In this review, we describe how SD-OCT, EDI-OCT, autofluorescence, wide-angle photography and wide-angle angiography have facilitated the evaluation of eyes with the more common vascular tumours, that is, choroidal haemangioma, retinal vasoproliferative tumours, and retinal haemangioblastoma.
最常见的眼内血管性肿瘤包括脉络膜血管瘤、血管性增殖肿瘤和视网膜血管母细胞瘤。较罕见的情况包括海绵状视网膜血管瘤和动静脉畸形。肿瘤消融的选择包括光动力疗法、氩激光光凝、经巩膜透热疗法、冷冻疗法、抗血管生成药物、放射性贴敷治疗和质子束放疗。常见的继发性效应包括视网膜渗出、黄斑水肿、视网膜内膜、视网膜纤维化，以及浆液性和牵引性视网膜脱离，这些可通过标准方法治疗（即眼内抗血管生成药物或类固醇以及玻璃体视网膜手术，如视网膜内膜剥除和解除视网膜牵引）。由于成像技术的进步，血管性肿瘤及其并发症的检测、诊断和监测得到了极大的改善。这些技术包括光谱域和增强深度成像光学相干断层扫描（分别为 SD-OCT 和 EDI-OCT）、广角摄影和血管造影以及广角眼底自发荧光。这些新型成像提供了新的诊断线索，并深刻影响了治疗策略，使得血管性肿瘤及其继发性效应现在可以同时治疗，而不是顺序治疗，从而提高了保护视力和眼睛的机会。在这篇综述中，我们描述了 SD-OCT、EDI-OCT、自发荧光、广角摄影和广角血管造影如何有助于评估更常见的血管性肿瘤（即脉络膜血管瘤、视网膜血管性增殖肿瘤和视网膜血管母细胞瘤）的眼睛。
