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视网膜血管增生性肿瘤的临床特征

Clinical Profiles of Retinal Vasoproliferative Tumors.

作者信息

Subramanian Brughanya, Nangia Purna, Rishi Pukhraj, Walinjkar Jaydeep Avinash, Ratra Dhanashree, Vadivelu Jaya Prakash, Majumder Parthopratim Dutta, Biswas Jyotirmay, Raman Rajiv

机构信息

Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.

Truhlsen Eye Institute, University of Nebraska Medical Centre, Omaha, NE, USA.

出版信息

J Vitreoretin Dis. 2024 Nov 14:24741264241296464. doi: 10.1177/24741264241296464.

Abstract

To describe the clinical features and treatment outcomes of patients with retinal vasoproliferative tumors. This retrospective case series comprised patients diagnosed with a retinal vasoproliferative tumor. Electronic medical records were reviewed, and patients' demographic details, clinical presentation, and treatment outcomes were analyzed. Nineteen eyes of 19 patients with vasoproliferative tumors were included. The mean age (±SD) at presentation was 37.0 ± 16.95 years. No eye had bilateral tumors, and 1 eye had multiple tumors. Three eyes (15%) had primary tumors, while 16 (84%) had secondary tumors. Primary tumors mainly affected the inferotemporal quadrant (n = 3). Secondary tumors involved the inferior quadrant (n = 4), inferotemporal quadrant (n = 5), and inferonasal quadrant (n = 5). Secondary tumors were associated with Coats disease (n = 6), intermediate uveitis (n = 3), traumatic chorioretinopathy (n = 2), familial exudative vitreoretinopathy (n = 2), retinal vasculitis (n = 2), and retinal vascular occlusion (n = 1). Retinochoroidal features included intraretinal and subretinal exudates, subretinal fluid, intraretinal hemorrhaging, vitreous hemorrhaging, cystoid macular edema, vitritis, preretinal fibrosis, dilated feeding vessel, epiretinal membranes, and tractional retinal detachment. Treatment modalities included cryotherapy, laser photocoagulation, and local steroids. The mean follow-up was 25.3 months, during which 18 eyes had tumor regression and 1 had a worsening condition. Secondary vasoproliferative tumors were more frequently observed than primary tumors, often presenting as unilateral, unifocal tumors situated posterior to the equator in the inferior fundus. Conventional treatment approaches, such as cryotherapy and laser photocoagulation, were effective at tumor regression and often required multiple sessions.

摘要

描述视网膜血管增生性肿瘤患者的临床特征及治疗结果。本回顾性病例系列研究纳入了诊断为视网膜血管增生性肿瘤的患者。查阅电子病历,并分析患者的人口统计学细节、临床表现及治疗结果。纳入了19例患有血管增生性肿瘤患者的19只眼。就诊时的平均年龄(±标准差)为37.0±16.95岁。无双眼肿瘤病例,1只眼有多个肿瘤。3只眼(15%)为原发性肿瘤,16只眼(84%)为继发性肿瘤。原发性肿瘤主要累及颞下象限(n = 3)。继发性肿瘤累及下象限(n = 4)、颞下象限(n = 5)和鼻下象限(n = 5)。继发性肿瘤与科茨病(n = 6)、中间葡萄膜炎(n = 3)、外伤性脉络膜视网膜病变(n = 2)、家族性渗出性玻璃体视网膜病变(n = 2)、视网膜血管炎(n = 2)和视网膜血管阻塞(n = 1)相关。视网膜脉络膜特征包括视网膜内和视网膜下渗出、视网膜下液、视网膜内出血、玻璃体积血、黄斑囊样水肿、玻璃体炎、视网膜前纤维化、扩张的供血血管、视网膜前膜和牵拉性视网膜脱离。治疗方式包括冷冻疗法、激光光凝和局部类固醇。平均随访时间为25.3个月,在此期间18只眼肿瘤消退,1只眼病情恶化。继发性血管增生性肿瘤比原发性肿瘤更常见,常表现为位于赤道后下方眼底的单侧、单灶性肿瘤。冷冻疗法和激光光凝等传统治疗方法对肿瘤消退有效,且通常需要多次治疗。

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