色素性脉络膜占位1例

A case of melanotic choroidal mass

37岁女性,因"右眼视物变形伴眼前黑影遮挡5 d"就诊,查体右眼黄斑区可见一橘红色肿块表面覆盖一层均匀色素,随访期间,色素迅速散开。根据B超及光学相干层析成像(OCT)的提示,诊断为脉络膜骨瘤。此后又继发脉络膜新生血管(CNV),予以抗血管内皮生长因子(VEGF)治疗后,CNV控制稳定后又趋于不断增长。讨论体会:脉络膜骨瘤可表现为色素性隆起的肿块,抗VEGF对骨瘤继发CNV有效,但其CNV的转归与继发于其他黄斑疾病的CNV不同,提示骨瘤新生血管可能具有独特的病理特点。

A 37-year-old woman presented with 5 days of metamorphopsia in her right eye.Fundus examination revealed a well-demarcated,elevated,orange-red-colored mass at the macula with centrally covered pigmentation.At follow-up,this pigmentation gradually dispersed.B-scan ultrasonography and EDI-OCT showed a diagnosis of choroidal osteoma.After anti-VEGF treatment,CNV stabilized and tended to increase continuously.Choroidal osteoma may present as a melanotic mass.Anti-VEGF is effective in CNV secondary to osteoma,but treatment outcome is different from those CNV secondary to other common macular diseases,suggesting that osteoma neovascular network may have unique pathological characteristics.