Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania; Ocular Oncology Service, Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Ophthalmol Retina. 2022 Jan;6(1):80-88. doi: 10.1016/j.oret.2021.04.007. Epub 2021 Apr 20.
To report the efficacy of photodynamic therapy (PDT) for management of retinal hemangioblastoma.
Retrospective case series.
Seventeen patients with retinal hemangioblastoma treated with PDT.
The medical records of 17 patients with retinal hemangioblastoma treated with PDT were reviewed, and treatment outcomes were assessed. Photodynamic therapy was performed with 6 mg/m body surface area of verteporfin infused intravenously over 10 minutes activated by 50 J/cm laser light at 689 nm for 83 or 166 seconds.
Tumor control, subretinal and intraretinal fluid resolution, and visual outcome.
Eighteen retinal hemangioblastomas in 17 eyes were treated with PDT. Median patient age was 31 years (mean, 36 years; range, 7-66 years), and median follow-up was 51 months (mean, 61 months; range, 2-144 months). Genetic testing confirmed von Hippel-Lindau disease in 8 of 17 patients (47%). The tumors were unilateral in all patients and unifocal in most patients (n = 13/17 [76%]). The tumor median basal diameter was 3.5 mm (mean, 3.4 mm; range, 1.5-6.0 mm) and median thickness was 2.1 mm (mean, 2.3 mm; range, 1.0-5.0 mm). The tumor location was juxtapapillary in 9 of 18 cases (50%). Associated findings included subretinal fluid (n = 14/17 [82%]) and macular edema (n = 12/17 [71%]). The median number of PDT sessions was 1.5 (mean, 1.8; range, 1.0-4.0). Standard duration of PDT (83 seconds) was used in all cases except 2, in which double duration (166 seconds) was used. Outcomes revealed tumor control in 13 of 18 tumors (72%), partial or complete resolution of subretinal fluid in 10 of 14 eyes (71%), and partial or complete resolution of macular edema in 7 of 12 eyes (58%), and stable or improved visual acuity in 12 of 17 eyes (71%). Photodynamic therapy-related transient exudative response was noted in 4 of 17 eyes (24%).
Photodynamic therapy is an effective treatment for both juxtapapillary and peripheral retinal hemangioblastomas, providing satisfactory rates of tumor control and visual stabilization and improvement. Patients should be monitored for PDT-related transient exudative response.
报告光动力疗法（PDT）治疗视网膜血管母细胞瘤的疗效。
回顾性病例系列。
17 例接受 PDT 治疗的视网膜血管母细胞瘤患者。
回顾性分析了 17 例接受 PDT 治疗的视网膜血管母细胞瘤患者的病历资料，并评估了治疗结果。静脉内输注 6mg/m 体表面积的维替泊芬，持续 10 分钟，然后用 689nm 激光光激活，能量为 50J/cm，照射 83 或 166 秒。
肿瘤控制、视网膜下和视网膜内液的缓解以及视力结果。
17 例患者的 18 个视网膜血管母细胞瘤接受 PDT 治疗。中位患者年龄为 31 岁（平均年龄 36 岁；范围 7-66 岁），中位随访时间为 51 个月（平均 61 个月；范围 2-144 个月）。8 例（47%）患者通过基因检测证实存在 von Hippel-Lindau 病。所有患者的肿瘤均为单侧，多数患者为单灶性（n=13/17 [76%]）。肿瘤的中位基底直径为 3.5mm（平均 3.4mm；范围 1.5-6.0mm），中位厚度为 2.1mm（平均 2.3mm；范围 1.0-5.0mm）。肿瘤位置在视盘旁的有 9 例（50%）。相关发现包括视网膜下液（n=14/17 [82%]）和黄斑水肿（n=12/17 [71%]）。PDT 治疗的中位次数为 1.5 次（平均 1.8 次；范围 1.0-4.0 次）。除 2 例外，所有病例均采用标准时长（83 秒）的 PDT，2 例采用双倍时长（166 秒）。结果显示，18 个肿瘤中有 13 个（72%）肿瘤得到控制，14 只眼中有 10 只（71%）视网膜下液完全或部分缓解，12 只眼中有 7 只（58%）黄斑水肿完全或部分缓解，17 只眼中有 12 只（71%）视力稳定或提高。17 只眼中有 4 只（24%）出现 PDT 相关的短暂渗出性反应。
光动力疗法是治疗视盘旁和周边视网膜血管母细胞瘤的有效方法，可获得满意的肿瘤控制率和视力稳定及改善率。应监测患者 PDT 相关的短暂渗出性反应。
