Treatment of Small-Sized Retinal Hemangioma by Intravitreal Bevacizumab (Avastin) Injection Combined With Laser Photocoagulation

以玻璃體內注射癌思停藥物合併雷射光凝固療法治療小型視網膜血管瘤

朱筱桑(Hsiao-Sang Chu) ； 葉伯廷(Po-Ting Yeh) ； 陳慕師(Muh-Shy Chen) ； 劉寬鎔(Kwan-Rong Liu) ； 楊中美(Chung-May Yang)

《中華民國眼科醫學會雜誌》 49卷3期 (2010/09) Pp. 348-353

https://doi.org/10.30048/ACTASOS.201009.0013

摘要

Purpose: To evaluate the efficacy of intravitreal bevacizumab (Avastin) injection combined with laser photocoagulation for small retinal hemangioma.
Methods: Interventional case report.
Result: A 20-year-old man with von Hippel-Lindau disease developed severe exudative retinal detachment with no light perception vision secondary to multiple retinal hemangiomas in his right eye. The left eye developed two small retinal angiomatous lesions in the midperipheral retina. A single dose of intravitreal Avastin (1.25 mg in 0.05 ml) was given. Evolution of the lesions was assessed by fundus examination and color photography. After treatment, the two retinal hemangiomas showed reduced size and vascularity within 2 weeks. Signs of recurrence were noted at the 2-month follow-up. The tumors responded promptly after the second Avastin injection but again recurred after two months. A third Avastin injection was given followed by laser photocoagulation 2 weeks later on the two lesions. The tumors regressed and scarred down after the treatment. Best-corrected visual acuity remained 20/20 during the two-year follow-up.
Conclusion: Intravitreal Avastin injection may promptly though temporally reduce the size and vascularity of small retinal hemangioma. Avastin combined with laser photocoagulation may achieve a long-lasting effect.

並列摘要

目的：報告一例以玻璃體內注射癌思停(Avastin)藥物合併雷射光凝固療法治療逢希伯•林道症候群併小型視網膜血管瘤案例。
方法：病例報告。
結果：二十歲之逢希伯•林道症候群男性病患患有兩側視網膜血管瘤。病患接受玻璃體內癌思停藥物注射以治療左眼網膜中外緣兩小型血管瘤。第一次注射後兩週，血管瘤體積消退，兩個月後回復到注射前大小。再次注射癌思停藥物，亦觀察到同樣消退後再復發情形。病患於第三次癌思停注射後，合併實施雷射光凝固治療。治療後血管瘤消退並結痂，兩年內病況及視力穩定。
結論：玻璃體內抗血管內皮增生藥物癌思停注射，具有短暫性降低血管瘤血管分佈之作用，搭配雷射光凝固治療，可能是有效長期治療小型視網膜血管瘤的方法。

並列關鍵字

Bevacizumab Avastin ； von Hippel-Lindau disease ； Retinal hemangioma ； Laser photocoagulation