Zheng Bin, Chen Yan, Chen Lifeng, Chen Huan, Zheng Jingwei, Chen Feng, Song Zongming, Fu Lin, Hu Xuting, Pan Jiandong, Lian Hengli, Shen Lijun, Li Qiuming
The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.
Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
J Ophthalmol. 2019 Jan 2;2019:7464123. doi: 10.1155/2019/7464123. eCollection 2019.
To investigate the efficacy and safety of combined vitrectomy with tumor resection in the treatment of retinal vasoproliferative tumors (RVPT).
Retrospective study. RVPT patients who underwent vitreous surgery at the Eye Hospital of Wenzhou Medical University from January 2011 to July 2017 were included. The main outcomes included treatment type, tumor activity, and best-corrected visual acuity (BCVA).
Altogether, 16 patients with 17 eyes were enrolled with follow-up of no less than 6 months. Eight eyes were in the resection treatment group (Group R) and 9 eyes were in the conservative treatment group (Group C). Female (69%) were more common. The mean age was 50 (49.72 ± 12.92) years. Fifteen patients got unilateral onset and only one patient suffered bilaterally. The common symptoms were decreased visual acuity, floaters, and visual distortion. The preoperative BCVA ranged from hand movement to 20/20, with an average of 0.82 ± 0.75 LogMAR. Patients were all not high myopia, with a mean axial length of 23.27 ± 0.27 mm (21.61 mm to 24.67 mm). Of the retinal diseases, the epiretinal membrane was the most common, followed by vitreous hemorrhage, uveitis, subretinal fluid, and so on. Compared with the baseline BCVA, it improved more at postoperative 6 months and the last visit in Group R than in Group C (=0.006 and =0.033). The BCVA-improved 0.2 LogMAR or above in 6 months was 2 eyes in Group C and 7 eyes in Group R. All tumors in Group R were completely resected, whereas three in Group C (33.3%) had definite activity (=0.008). In all samples, tumors were located on the inner side of the retina and had small vessel wall thickening and hyaline degeneration. The degree of astrocyte proliferation varies widely among different tumors.
RVPT was more likely to occur in nonhigh myopia patients. Epiretinal membrane and vitreous hemorrhage were the main causes for vitreous surgery in RVPT patients. Compared with conservative treatment, surgical resection of the tumor is more beneficial to patients on visual acuity recovery and preventing tumor relapse. It is a safe and effective way to treat RVPT.
探讨玻璃体切除术联合肿瘤切除术治疗视网膜血管增生性肿瘤（RVPT）的疗效及安全性。
回顾性研究。纳入2011年1月至2017年7月在温州医科大学附属眼视光医院接受玻璃体手术的RVPT患者。主要观察指标包括治疗方式、肿瘤活性及最佳矫正视力（BCVA）。
共纳入16例患者的17只眼，随访时间不少于6个月。切除治疗组（R组）8只眼，保守治疗组（C组）9只眼。女性患者更为常见（69%）。平均年龄为50（49.72±12.92）岁。15例患者为单眼发病，仅1例为双眼发病。常见症状为视力下降、飞蚊症和视物变形。术前BCVA范围从手动到20/20，平均为0.82±0.75 LogMAR。患者均非高度近视，平均眼轴长度为23.27±0.27 mm（21.61 mm至24.67 mm）。在视网膜疾病中，视网膜前膜最为常见，其次是玻璃体积血、葡萄膜炎、视网膜下液等。与基线BCVA相比，R组术后6个月及末次随访时视力改善程度均优于C组（P = 0.006和P = 0.033）。6个月内BCVA提高0.2 LogMAR及以上的，C组有2只眼，R组有7只眼。R组所有肿瘤均完全切除，而C组有3只眼（33.3%）肿瘤有明确活性（P = 0.008）。在所有样本中，肿瘤位于视网膜内侧，有小血管壁增厚和玻璃样变性。不同肿瘤间星形胶质细胞增生程度差异较大。
RVPT更易发生于非高度近视患者。视网膜前膜和玻璃体积血是RVPT患者行玻璃体手术的主要原因。与保守治疗相比，手术切除肿瘤对患者视力恢复及预防肿瘤复发更有益。是治疗RVPT的一种安全有效的方法。
