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基于光动力疗法或光凝疗法治疗视网膜毛细血管瘤的长期治疗效果

Long-Term Therapeutic Outcomes of Photodynamic Therapy-Based or Photocoagulation-Based Treatments on Retinal Capillary Hemangioma.

作者信息

Huang Chuangxin, Tian Zhen, Lai Kunbei, Zhong Xiaojin, Zhou Lijun, Xu Fabao, Yang Huasheng, Lu Lin, Jin Chenjin

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou, China .

出版信息

Photomed Laser Surg. 2018 Jan;36(1):10-17. doi: 10.1089/pho.2017.4296. Epub 2017 Oct 25.

Abstract

BACKGROUND

Retinal capillary hemangioma (RCH) is a rare and refractory eye tumor.

OBJECTIVE

The aim of this study was to investigate the therapeutic efficacy of two laser-based therapies for RCH, photodynamic therapy (PDT), and focal photocoagulation-based treatment.

MATERIALS AND METHODS

This was a retrospective study. Eight RCH patients (10 eyes) receiving laser treatment and followed up from November 2011 to December 2016 in our hospital were selected and their medical records reviewed. Clinical results and correlations between various clinicodemographic factors and vision outcome were analyzed.

RESULTS

A total of 39 RCH tumor bodies were found and treated. Eleven sessions of PDT and 25 sessions of photocoagulation were administered. Other treatments included five intravitreal injections of antivascular endothelial growth factor or triamcinolone acetonide and one vitreoretinal surgery. After the follow-up period of 54.3 ± 29.8 months, 35 tumor bodies were stable or regressed, and 4 were recurrent. Vision was improved in four eyes, stable in one, and reduced in five relative to baseline. Photocoagulation was more likely to induce tumor bleeding than PDT (4 eyes vs. 1) and to increase subretinal fluid (3 eyes vs. 1). In correlation analysis, subretinal fluid accumulation was predictive of poor vision outcome (r = 0.69, p = 0.03).

CONCLUSIONS

Photodynamic- and photocoagulation-based therapies are both reasonably effective against most RCH tumor bodies, but PDT carries lower risks of bleeding and subretinal fluid refraction. Formation of subretinal fluid may predict poor vision outcome in RCH.

摘要

背景

视网膜毛细血管瘤(RCH)是一种罕见且难治的眼部肿瘤。

目的

本研究旨在探讨两种基于激光的RCH治疗方法,即光动力疗法(PDT)和基于局灶性光凝的治疗方法的疗效。

材料与方法

这是一项回顾性研究。选取2011年11月至2016年12月在我院接受激光治疗并随访的8例RCH患者(10只眼),回顾其病历资料。分析临床结果以及各种临床人口统计学因素与视力预后之间的相关性。

结果

共发现并治疗39个RCH瘤体。进行了11次PDT治疗和25次光凝治疗。其他治疗包括5次玻璃体内注射抗血管内皮生长因子或曲安奈德以及1次玻璃体视网膜手术。在54.3±29.8个月的随访期后,35个瘤体稳定或消退,4个复发。与基线相比,4只眼视力改善,1只眼稳定,5只眼视力下降。光凝比PDT更易导致肿瘤出血(4只眼对1只眼)和视网膜下液增加(3只眼对1只眼)。在相关性分析中,视网膜下液积聚可预测视力预后不良(r = 0.69,p = 0.03)。

结论

基于光动力和光凝的疗法对大多数RCH瘤体均有合理疗效,但PDT导致出血和视网膜下液屈光的风险较低。视网膜下液的形成可能预示RCH患者视力预后不良。

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