Won Yeo Kyoung, Lee Min Woo, Shin Yong Il, Kim Jung Yeul, Jo Young Joon
Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.
Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.
Korean J Ophthalmol. 2020 Apr;34(2):133-142. doi: 10.3341/kjo.2019.0075.
We report the clinical outcomes of retinal capillary hemangioma (RCH) after the application of various treatments.
We performed a retrospective chart analysis of eight eyes treated for RCH between August 2009 and January 2018. During the follow-up period, the status and progression of the RCHs were checked by fundus photography, fluorescein angiography, and optical coherence tomography, and additional treatments were applied when necessary.
Three of the five patients had bilateral RCH, and two had unilateral RCH. Six eyes received laser photocoagulation; two eyes received cryotherapy, and one eye received intravitreal Avastin injection. Three eyes each had intravitreal triamcinolone injection, subtenon triamcinolone injection, and intravitreal dexamethasone injection to control inflammation. Also, two patients took oral prednisolone, and one patient used prednisolone eye drops to control inflammation. Two eyes underwent vitrectomy and scleral buckling due to deterioration of the epiretinal membrane and vitreal traction, respectively. As a result of those treatments, the tumors were stable in five of the eight eyes. However, one eye is now in a pre-phthisis state, and one patient who refused treatment showed progression of the tumor, epiretinal membrane, and traction.
Because RCHs vary in size, the degree of inflammation, and symptoms, this disorder should be actively treated on a case-by-case basis. Fluorescein angiography should be used periodically to determine recurrence of the tumor or inflammation, and the appropriate treatment should be repeated as necessary. Moreover, regular systemic screening tests for von Hippel-Lindau disease should be performed in RCH patients to ensure that they have no abnormalities other than in the eye.
我们报告了应用各种治疗方法后视网膜毛细血管瘤(RCH)的临床结果。
我们对2009年8月至2018年1月期间接受RCH治疗的8只眼进行了回顾性病历分析。在随访期间,通过眼底照相、荧光素血管造影和光学相干断层扫描检查RCH的状态和进展,并在必要时进行额外治疗。
5例患者中有3例为双侧RCH,2例为单侧RCH。6只眼接受了激光光凝治疗;2只眼接受了冷冻治疗,1只眼接受了玻璃体内阿瓦斯汀注射。3只眼分别接受了玻璃体内曲安奈德注射、球后曲安奈德注射和玻璃体内地塞米松注射以控制炎症。此外,2例患者口服泼尼松龙,1例患者使用泼尼松龙眼药水控制炎症。2只眼分别因视网膜前膜恶化和玻璃体牵引而接受了玻璃体切除术和巩膜扣带术。经过这些治疗,8只眼中有5只眼的肿瘤保持稳定。然而,1只眼目前处于眼球痨前期状态,1例拒绝治疗的患者出现了肿瘤、视网膜前膜和牵引的进展。
由于RCH的大小、炎症程度和症状各不相同,应根据具体情况积极治疗这种疾病。应定期使用荧光素血管造影来确定肿瘤或炎症的复发情况,并根据需要重复进行适当的治疗。此外,应对RCH患者定期进行系统性的冯·希佩尔-林道病筛查,以确保他们除眼部外没有其他异常。