单次光动力治疗后极部孤立性小病灶脉络膜血管瘤后黄斑形态及视功能变化

Changes of macular morphology and visual function in choroidal hemangioma with isolated small lesions after single photodynamic therapy

目的观察单次光动力治疗(PDT)对波及黄斑的后极部孤立性小病灶脉络膜血管瘤(PSCCH)黄斑形态和视功能变化的影响。方法回顾性自身对照研究,选取2014年1月至2019年1月在我院接受PDT的11例PSCCH患者为研究对象。根据手术前后患者眼底彩色照相(FP)、眼底荧光血管造影(FFA)、吲哚青绿血管造影(ICGA)、眼部B超、光学相干断层扫描(OCT)检查结果,评价患者治疗前后最佳矫正视力(BCVA)、黄斑中心凹下视网膜厚度(FSRT)、瘤体基底最大直径和厚度的变化。所有患者均接受单次PDT治疗。术后随访1~24个月。结果所有患者术后瘤体缩小,瘤体厚度从术前(2.318±0.725)mm降低到术后瘤体数据不可测,瘤体部位视网膜下液吸收,渗出性脱离减轻,中心凹形态恢复正常。FSRT由术前(876.09±483.74)μm降至术后(201.9±62.6)μm,差异有统计学意义(P<0.05)。BCVA从术前的(0.27±0.33)增加到(0.35±0.40),差异有统计学意义(P<0.05)。无患者发生治疗相关并发症;随访期间未见患者肿瘤复发。结论单次PDT治疗PSCCH可以缩小瘤体,恢复黄斑形态,稳定视功能。

Objective To observe the changes of macular morphology and visual function in post pole small circumscribed choroidal hemangioma(PSCCH)by single photodynamic therapy(PDT).Methods A retrospective self-controlled study was performed in 11 patients with PSCCH who underwent PDT in our hospital from January 2014 to January 2019.According to fundus photochromy(FP),fundus fluorescein angiography(FFA),indocyanine green angiography(ICGA),B-mode ultrasound,and optical coherence tomography(OCT),changes of the best corrected visual acuity(BCVA),foveal subretinal thickness(FSRT),maximum diameter and thickness of the tumor were evaluated.All the patients received PDT one time,and they were followed-up for 1 to 24 months.Results Postoperative tumor shrinkage was observed in all patients,and the thickness of the tumor was reduced from(2.318±0.725)mm to no data can be measured.The subretinal fluid was absorbed,the exudative detachment was relieved,and the foveal morphology returned to normal.The FSRT was reduced from(876.09±483.74)μm to(201.9±62.6)μm,with statistically significant difference(P<0.05).The BCVA of 11 patients increased from(0.27±0.33)to(0.35±0.40),and the difference was statistically significant(P<0.05).None of the patients had treatment-related complications.And there was no recurrence of the tumor during the follow-up period.Conclusion A single PDT for the treatment of PSCCH can reduce the tumor volume,restore the macular morphology,and stabilize the visual function.