Kikuchi Iku, Kase Satoru, Hashimoto Yuki, Hirooka Kiriko, Ishida Susumu
Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N-15, W-7, Kita-ku, Sapporo, 060-8638, Japan.
Graefes Arch Clin Exp Ophthalmol. 2019 Apr;257(4):835-841. doi: 10.1007/s00417-019-04257-7. Epub 2019 Feb 4.
This study aims to examine the relationship between ocular circulation changes and visual field defects in optic disk melanocytoma (ODM).
Five eyes of five patients were enrolled in this study. All patients were diagnosed with ODM in the Department of Ophthalmology, Hokkaido University Hospital from March 2009 to November 2017. Ophthalmological data including optical coherence tomography angiography (OCTA) and laser speckle flowgraphy (LSFG) findings were retrospectively analyzed.
The five ODM cases consisted of two females and three males. Ages of the patients ranged from 47 to 82 years (mean 54 years). Follow-up periods were from 4 to 105 months. Fluorescein angiography showed hypo-fluorescence throughout the examination in all four eyes examined with this modality. OCTA detected dense blood vessel networks in the tumor in two out of the five eyes. Nasal visual field defects were found in two other eyes, which were correlated with locations of tumors free of vessel networks. One ODM eye without marked visual field defects and pigmentations showed lower mean blur rates determined by LSFG in optic disk vessels and tissue circulations than those in the contralateral eye. During follow-up, there was no tumor enlargement in any case.
This study showed the relationship between the deficit of blood vessel networks and visual field defects in ODM patients. LSFG demonstrated reduced blood flow in the tumor, suggesting that circulatory disorder caused by the optic disk tumor might be correlated with visual field defect.
本研究旨在探讨视盘黑色素细胞瘤（ODM）患者眼循环变化与视野缺损之间的关系。
本研究纳入了5例患者的5只眼睛。所有患者均于2009年3月至2017年11月期间在北海道大学医院眼科被诊断为ODM。对包括光学相干断层扫描血管造影（OCTA）和激光散斑血流图（LSFG）检查结果在内的眼科数据进行了回顾性分析。
5例ODM患者中，女性2例，男性3例。患者年龄在47至82岁之间（平均54岁）。随访时间为4至105个月。荧光素血管造影显示，在接受该检查的4只眼中，整个检查过程均表现为低荧光。OCTA在5只眼中的2只检测到肿瘤内有密集的血管网络。另外2只眼出现鼻侧视野缺损，这与无血管网络的肿瘤位置相关。1只无明显视野缺损和色素沉着的ODM眼，其视盘血管和组织循环的LSFG平均模糊率低于对侧眼。随访期间，所有病例均未出现肿瘤增大。
本研究显示了ODM患者血管网络缺损与视野缺损之间的关系。LSFG显示肿瘤内血流减少，提示视盘肿瘤引起的循环障碍可能与视野缺损相关。
