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经玻璃体腔注射普萘洛尔治疗 von Hippel-Lindau 病相关视网膜毛细血管血管瘤

INTRAVITREAL INJECTION OF PROPRANOLOL FOR THE TREATMENT OF RETINAL CAPILLARY HEMANGIOMA IN A CASE OF VON HIPPEL-LINDAU.

机构信息

Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and.

出版信息

Retin Cases Brief Rep. 2020 Fall;14(4):305-309. doi: 10.1097/ICB.0000000000000718.

Abstract

PURPOSE

The purpose of this study was to evaluate the safety and efficacy of intravitreal propranolol for the management of retinal capillary hemangioma in a patient with Von Hippel-Lindau.

METHODS

Two intravitreal injections of 50 μg/0.05 mL propranolol were administered 6 weeks apart in the left eye of a 26-year-old patient with bilateral multiple retinal capillary hemangiomas. Safety and response to therapy were evaluated using electroretinogram, fluorescein angiography, and measurement of visual acuity. Laser photocoagulation was performed in the right eye.

RESULTS

One month after the second intravitreal injection of propranolol, fluorescein leakage decreased from the tumors located on the optic nerve head and in the inferonasal retinal periphery. Reduction of the retinal capillary hemangioma vascularity and enhancement of its fibrosis associated with the attenuation of the feeder vessel were also observed. Ophthalmic examination showed no adverse effect except for a mild transient vitreous haziness after each injection. Electroretinogram performed 4 weeks after the first injection revealed no retinal toxicity.

CONCLUSION

Intravitreal propranolol showed a therapeutic effect on retinal capillary hemangioma with no short-term adverse effects except a mild transient inflammatory response in a patient with Von Hippel-Lindau.

摘要

目的

本研究旨在评估玻璃体内普萘洛尔治疗 von Hippel-Lindau 患者视网膜毛细血管瘤的安全性和疗效。

方法

对 1 例双侧多发性视网膜毛细血管瘤患者的左眼,每 6 周行 1 次、每次 50μg/0.05mL 的玻璃体内普萘洛尔注射,共 2 次。通过视网膜电图、荧光素血管造影和视力测量评估安全性和治疗反应。右眼行激光光凝。

结果

玻璃体内注射普萘洛尔 2 次后 1 个月,视神经头部和鼻下视网膜周边的肿瘤处荧光素渗漏减少。还观察到视网膜毛细血管瘤血管减少和纤维化增强,伴滋养血管衰减。除每次注射后出现短暂性轻度玻璃体混浊外,眼部检查未见其他不良反应。首次注射后 4 周进行的视网膜电图检查未发现视网膜毒性。

结论

玻璃体内注射普萘洛尔对 von Hippel-Lindau 患者的视网膜毛细血管瘤有治疗作用,除轻度短暂炎症反应外,无短期不良反应。

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