Karimi Saeed, Nourinia Ramin, Mashayekhi Arman
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA, USA.
J Ophthalmic Vis Res. 2015 Jul-Sep;10(3):320-8. doi: 10.4103/2008-322X.170353.
Circumscribed choroidal hemangiomas are benign vascular hamartomas without systemic associations. Generally, they are orange-red elevated masses, which are found posterior to the equator. Lesions are usually solitary and unilateral. Overlying subretinal fluid, serous retinal detachment and cystoid macular edema are common findings. Intravenous fluorescein angiography, indocyanine green angiography, ultrasonography, optical coherence tomography and enhanced depth imaging are helpful ancillary tests for diagnosis of circumscribed choroidal hemangiomas. Asymptomatic circumscribed choroidal hemangiomas do not require treatment. For symptomatic lesions with exudative retinal detachment or cystoid macular edema, photodynamic therapy has emerged as the treatment of choice with high rates of tumor regression, subretinal fluid resorption and minimal complications. Lens-sparing external beam radiotherapy, plaque brachytherapy, proton beam therapy, stereotactic radiosurgery, transpupillary thermotherapy, laser photocoagulation and anti-VEGF injections are other treatment modalities.
局限性脉络膜血管瘤是一种无全身关联的良性血管错构瘤。通常,它们是橙红色隆起的肿物,位于赤道后方。病变通常为孤立性且单侧性。视网膜下液、浆液性视网膜脱离和黄斑囊样水肿是常见表现。静脉荧光素血管造影、吲哚菁绿血管造影、超声检查、光学相干断层扫描和增强深度成像对局限性脉络膜血管瘤的诊断是有帮助的辅助检查。无症状的局限性脉络膜血管瘤无需治疗。对于伴有渗出性视网膜脱离或黄斑囊样水肿的有症状病变,光动力疗法已成为首选治疗方法,肿瘤消退率、视网膜下液吸收率高且并发症极少。保留晶状体的外照射放疗、敷贴近距离放疗、质子束治疗、立体定向放射外科手术、经瞳孔温热疗法、激光光凝和抗血管内皮生长因子注射是其他治疗方式。