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随访 9 年后因脉络膜骨瘤导致的脉络膜新生血管。

Secondary choroidal neovascularization due to choroidal osteoma after 9 years follow-up.

机构信息

Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China.

Yongkang First People's Hospital of Hangzhou Medical College, Jinhua, Zhejiang, China.

出版信息

BMC Ophthalmol. 2021 May 31;21(1):242. doi: 10.1186/s12886-021-02004-3.

DOI:10.1186/s12886-021-02004-3
PMID:34058993
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8167975/
Abstract

BACKGROUND

Choroidal osteoma is a benign intraocular tumor that can increase risk of developing choroidal neovascularization. The visual prognosis is influenced by the tumor location, decalcification status, overlying RPE atrophy, presence of choroidal neovascularization, persistence of subretinal fluid and occurrence of subretinal hemorrhages.

CASE PRESENTATION

The authors present a 40-year-old woman diagnosed with choroidal osteoma of the right eye. Her best corrected visual acuity was 12/20 but decreased to 5/20 due to secondary choroidal neovascularization after 8 years follow up. Fundus examination revealed an enlarged choroidal osteoma in most margins at posterior pole with schistose hemorrhage beside macula. Optical coherence tomography angiography revealed unique features in the vascular changes of choroidal neovascularization in choroidal osteoma in the outer retinal layer and choroid capillary layers, and subretinal neovascularization. Indocyanine green fluorescence angiography showed there was hypo-fluorescence at the peripapillary with faint hyper-fluorescence at the macular, corresponding to the location on the fundus photograph. The patient received 3 injections of intravitreal ranibizumab. After 1 year follow up, her visual acuity of the right eye was 18/20 and the CNV had regressed.

CONCLUSIONS

We present the findings and treatment of a case of choroidal osteoma with secondary choroidal neovascularization. Optical coherence tomography angiography combined with FFA and ICGA is used to analysis the characteristics of secondary choroidal neovascularization. Optical coherence tomography angiography can reveal some unique characteristics in the vascular changes compared to fundus fluorescein angiography.

摘要

背景

脉络膜骨瘤是一种良性眼内肿瘤，可增加脉络膜新生血管形成的风险。肿瘤位置、脱钙状态、上皮下 RPE 萎缩、脉络膜新生血管形成、视网膜下液持续存在和视网膜下出血的发生都会影响到视力预后。

病例介绍

作者报告了一例 40 岁女性右眼脉络膜骨瘤患者。她的最佳矫正视力为 12/20，但在 8 年随访后由于继发脉络膜新生血管形成而降至 5/20。眼底检查显示后极部大多数边缘有扩大的脉络膜骨瘤，黄斑旁有条纹状出血。光学相干断层扫描血管造影显示脉络膜骨瘤脉络膜新生血管外层视网膜和脉络膜毛细血管层以及视网膜下新生血管的血管变化具有独特特征。吲哚青绿荧光血管造影显示视盘周围呈低荧光，黄斑处呈弱高荧光，与眼底照片的位置相对应。患者接受了 3 次玻璃体内雷珠单抗注射。1 年后随访时，右眼视力为 18/20，CNV 已消退。

结论

我们报告了一例继发脉络膜新生血管形成的脉络膜骨瘤病例的发现和治疗。光学相干断层扫描血管造影结合荧光血管造影和吲哚青绿血管造影用于分析继发脉络膜新生血管形成的特征。与眼底荧光血管造影相比，光学相干断层扫描血管造影可以显示血管变化的一些独特特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/f16cd9764fbf/12886_2021_2004_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/48be61dcc01c/12886_2021_2004_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/291243e4031f/12886_2021_2004_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/e96e90fa3b1b/12886_2021_2004_Fig5_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/e76eee987a58/12886_2021_2004_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/c626fb2abb88/12886_2021_2004_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/f16cd9764fbf/12886_2021_2004_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/48be61dcc01c/12886_2021_2004_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/598c800c25bd/12886_2021_2004_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/bd0e573af7f3/12886_2021_2004_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/291243e4031f/12886_2021_2004_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/e96e90fa3b1b/12886_2021_2004_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/e6030fa391ac/12886_2021_2004_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/e76eee987a58/12886_2021_2004_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/c626fb2abb88/12886_2021_2004_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82d/8167975/f16cd9764fbf/12886_2021_2004_Fig9_HTML.jpg

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