Saito Tsunehiro, Hirota Kazunari, Inoue Makoto, Nomura Masahiro, Okada Annabelle A, Hirakata Akito
Department of Ophthalmology, Kyorin University School of Medicine, Japan.
Department of Ophthalmology, Tachikawa KKK hospital, Japan.
Nippon Ganka Gakkai Zasshi. 2014 Jan;118(1):33-9.
We compared therapeutic outcomes in two cases of juxtapapillary capillary hemangiomas associated with von Hippel-Lindau disease.
Case 1 was a 47-year-old man whose left eye was blind due to proliferative vitreoretinopathy. Visual acuity of the right eye was 1.2. No exudative change was found, but the juxtapapillary retinal hemangioma was enlarged. Three injections of intravitreal bevacizmab were not effective and laser photocoagulation was performed. Humphry microperimetry revealed a decreased sensitivity corresponding to the papillo-macular bundle damage. Vision was restored with regression of the retinal hemangioma. Case 2 was a 36-year-old woman with bilateral visual acuity of 1.2. The right eye had an inferior juxtapapillary retinal hemangioma at the optic disc surrounded by exudative retinal detachment. Laser photocoagulation, intravitreal injection of bevacizmab, transpapillary thermotherapy, photodynamic therapy, and vitrectomy were performed, but vision decreased to 0.02.
Photocoagulation in the early stage of juxtapapillary hemangioma before development of exudative detachment may preserve visual acuity.
我们比较了两例与冯·希佩尔-林道病相关的视乳头旁毛细血管瘤的治疗效果。
病例1为一名47岁男性,其左眼因增殖性玻璃体视网膜病变而失明。右眼视力为1.2。未发现渗出性改变,但视乳头旁视网膜血管瘤增大。三次玻璃体内注射贝伐单抗均无效,遂进行激光光凝治疗。汉弗莱微视野计检查显示与乳头黄斑束损伤相应的敏感度降低。随着视网膜血管瘤消退,视力得以恢复。病例2为一名36岁女性,双眼视力均为1.2。右眼在视盘下方有一个视乳头旁视网膜血管瘤,周围伴有渗出性视网膜脱离。进行了激光光凝、玻璃体内注射贝伐单抗、经乳头温热疗法、光动力疗法和玻璃体切除术,但视力降至0.02。
在渗出性脱离发生之前对视乳头旁血管瘤的早期进行光凝治疗可能会保留视力。