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血管性增殖性肿瘤的黄斑后遗症:手术方法的结果。

Macular sequelae in vasoproliferative tumors: results of surgical approach.

机构信息

Department of Ophthalmology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece.

Department of Ophthalmology, University of Thessaly, Larissa, Greece.

出版信息

Int Ophthalmol. 2021 Oct;41(10):3515-3522. doi: 10.1007/s10792-021-01918-7. Epub 2021 Jun 25.

DOI:10.1007/s10792-021-01918-7
PMID:34173151
Abstract

PURPOSE

The purpose of this study is to report the clinical manifestations and treatment outcomes in three patients diagnosed with vasoproliferative tumors (VPTs).

METHODS

A retrospective, single-center case series was conducted, and retinal findings from three cases were documented by clinical examination and multimodal imaging.

RESULTS

Three patients presented with an elevated, yellow-white retinal lesion located at the peripheral retina and extensive retinal exudation. All three patients were closely monitored, and tumor-associated features included lipid exudates, cystoid macular edema (CMO), pre-retinal fibrosis and epi-retinal membrane (ERM). Clinical management relied on observation, cryotherapy, laser photocoagulation, intravitreal steroids and anti-vascular endothelial growth factor (anti-VEGF) treatment. Despite different clinical courses, two patients underwent vitreo-retinal surgery to address VPT-related complications of macular hole and vitreo-macular traction, whereas a patient underwent phacoemulsification to treat steroid-induced cataract.

CONCLUSION

VPTs are uncommon benign vascular tumors and usually located at the infero-temporal peripheral retina. Close observation and early diagnosis of VPTs are of great importance in preventing vision-threatening complications and ensuring the best final visual outcome. The optimal treatment has yet to be defined due to lack of multi-center clinical studies. Despite the availability of less invasive therapeutic interventions, however, our case series show that pars plana vitrectomy is sometimes the most appropriate choice to restore visual acuity.

摘要

目的

本研究旨在报告三例诊断为血管性增殖性肿瘤(VPT)患者的临床表现和治疗结果。

方法

进行了回顾性、单中心病例系列研究,通过临床检查和多模态成像记录了三例病例的视网膜表现。

结果

三名患者表现为位于周边视网膜的隆起、黄白色视网膜病变和广泛的视网膜渗出。所有三名患者均密切监测,肿瘤相关特征包括脂质渗出、囊样黄斑水肿(CMO)、视网膜前纤维化和视网膜内膜(ERM)。临床治疗依赖于观察、冷冻疗法、激光光凝、玻璃体内皮质类固醇和抗血管内皮生长因子(抗 VEGF)治疗。尽管临床病程不同,但两名患者因黄斑裂孔和玻璃体内膜牵引等 VPT 相关并发症而行玻璃体视网膜手术,而一名患者因类固醇诱导性白内障而行超声乳化术。

结论

VPT 是罕见的良性血管肿瘤,通常位于下颞部周边视网膜。密切观察和早期诊断 VPT 对于预防威胁视力的并发症和确保最佳最终视力结果非常重要。由于缺乏多中心临床研究,因此尚未确定最佳治疗方法。尽管有较少侵入性的治疗干预措施,但我们的病例系列表明,玻璃体切除术有时是恢复视力的最佳选择。

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Int Ophthalmol. 2020 Aug;40(8):2095-2102. doi: 10.1007/s10792-020-01386-5. Epub 2020 May 2.
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VASOPROLIFERATIVE TUMORS IN INTERMEDIATE UVEITIS.中间葡萄膜炎相关的血管性肿瘤。
Retina. 2020 Sep;40(9):1765-1773. doi: 10.1097/IAE.0000000000002656.
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Clinical features and treatment outcomes of vasoproliferative tumors in Indian participants.印度参与者的血管性增生性肿瘤的临床特征和治疗结果。
Indian J Ophthalmol. 2018 Feb;66(2):246-251. doi: 10.4103/ijo.IJO_210_17.
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Widening use of dexamethasone implant for the treatment of macular edema.地塞米松植入物在黄斑水肿治疗中的应用日益广泛。
Drug Des Devel Ther. 2017 Aug 16;11:2359-2372. doi: 10.2147/DDDT.S138922. eCollection 2017.
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