Gündüz K, Shields C L, Shields J A
Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Retina. 1998;18(4):343-7. doi: 10.1097/00006982-199807000-00009.
Varix of the vortex vein ampulla is a condition that can cause diagnostic confusion with choroidal melanoma.
A case series review was performed from the Ocular Oncology Service, Wills Eye Hospital.
In all four cases, the patients were referred with the diagnosis of a small choroidal melanoma. The lesions were located in the nasal quadrant of the fundus near the equator. One patient had two lesions in the same quadrant. In all cases, the fundus lesion became more prominent when the eye gazed in the direction of the lesion and diminished in primary gaze. The mass measured up to 6.0 mm in base diameter and 2.5 mm in thickness in proper gaze. B-scan ultrasonography showed acoustic solidity and gaze-evoked dynamic enlargement of the lesion. Indocyanine green angiography demonstrated early pooling of dye and gaze-evoked fluctuation of the hyperfluorescence in the lesion. Color Doppler imaging, performed in one patient, showed a vascular lesion of venous origin that filled when the eye was placed in the direction of the lesion.
Varix of the vortex vein is a condition that should be considered in the differential diagnosis of equatorial small choroidal melanoma. The dynamic nature of the lesion is characteristic and diagnostic.
涡静脉壶腹静脉曲张是一种可导致与脉络膜黑色素瘤诊断混淆的病症。
对威尔斯眼科医院眼肿瘤科的一系列病例进行回顾。
在所有4例病例中，患者均以小脉络膜黑色素瘤的诊断被转诊。病变位于赤道附近眼底的鼻侧象限。1例患者在同一象限有2个病变。在所有病例中，当眼睛注视病变方向时，眼底病变变得更加明显，而在第一眼位时则变小。在合适的注视位时，肿物基底直径最大达6.0 mm，厚度达2.5 mm。B超显示病变呈实性回声且注视诱发病变动态增大。吲哚青绿血管造影显示病变早期染料蓄积以及注视诱发的病变内高荧光波动。对1例患者进行彩色多普勒成像检查，显示为静脉起源的血管性病变，当眼睛转向病变方向时病变充盈。
涡静脉曲张是赤道部小脉络膜黑色素瘤鉴别诊断中应考虑的一种病症。病变的动态特性具有特征性且有助于诊断。
