Circumscribed Choroidal Hemangioma Comparison of Outcomes by Treatment with Laser Photocoagulation or Transpupillary Thermotherapy

侷限性脈絡膜血管瘤接受雷射光凝療法與經瞳孔熱雷射療法治療結果之比較

施智偉(Chih-Wei Shih) ； 楊長豪(Chang-Hao Yang) ； 楊中美(Chung-May Yang) ； 黃正賢(Jen-Shang Huang) ； 林昌平(Chang-Pin Lin) ； 何子昌(Tzyy-Chang Ho) ； 陳慕師(Muh-Shy Chen)

《中華民國眼科醫學會雜誌》 45卷4期 (2006/12) Pp. 359-366

https://doi.org/10.30048/ACTASOS.200612.0002

摘要

目的：比較接受雷射光凝療法與經瞳孔熱雷射療法治療的結果
方法：回顧自1995年1月至2004年7月之侷限性脈絡膜血管瘤接受雷射光凝療法或經瞳孔熱雷射療法治療之病例。紀錄病患的年齡、性別、追蹤時間、臨床症狀、視力、血管瘤位置和視網膜下積液的狀態。視力維持穩定在本篇研究定義為視力變化不超過Snellen視力表兩行。
結果：本研究包括14位病患的14隻眼睛。病人平均年齡是43歲，追蹤平均時問是15.4個月。7個病人視網膜中央窩有血管瘤或其引發之視網膜下積液。7個病人接受雷射光凝療法、7個病人接受經瞳孔熱雷射療法作為初次治療。接受雷射光凝療法的病人有2位(28%)視力有進步但不超過Snellen視力表兩行，有5位(71%)視網膜下積液完全吸收。接受經瞳孔熱雷射療法的病人有3位(42%)視力有進步但不超過Snellen視力表兩行，有5位(71%)視網膜下積液完全吸收。14位病患的視力在追蹤期間都維持穩定（不超過Snellen視力表兩行），其中7位病患的治療後視力小於0.1。
結論：本篇侷限性脈絡膜血管瘤的研究中，雷射光凝療法與經瞳孔熱雷射療法對視力和視網膜下積液的吸收有相似的效果。較差的視力預後和視網膜中央窩有血管瘤或其引發之視網膜下積液侵犯以及差的治療前視力有關。雖然視網膜下積液完全吸收的比率達到百分之七十一，但有百分之五十的病人治療後視力小於0.1。

並列摘要

Purpose: To compare the visual and anatomical results of cases of circumscribed choroidal hemangiomas after treated by laser photocoagulation or transpupillary thermotherapy (TTT).
Method: A retrospective review was performed on patients with circumscribed choroidal hemangiomas treated by photocoagulation or TTT between January 1995 and June 2004. Patients' age, gender, length of follow-up, visual symptoms, visual acuity at presentation and follow-up, tumor location, and the status of subretinal fluid were recorded. Stationary visual acuity was defined as changes of visual acuity within two lines on the Snellen chart before and after the treatment. Poor vision was defined as visual acuity less than 0.1.
Results: Fourteen eyes of 14 patients with symptomatic circumscribed choroidal hemangioma were included. The average age was 43 years old and they were followed for a mean of 15.4 months. Seven of the 14 patients had foveal involvement of the tumor or associated subretinal fluid. Seven patients received photocoagulation and 7 received TTT as the primary treatment. Of the 7 patients treated by laser photocoagulation, two (28%) had post treatment visual acuity better than that at presentation. None improved more than two Snellen lines of visual acuity. Complete resolution of subretinal fluid was noted in five patients (71%). Of the 7 patients treated by TTT, three (42%) had post treatment visual acuity better than that at presentation. None improved more than 2 lines of visual acuity. Five patients (71%) showed complete resolution of subretinal fluid. All of the 14 patients preserved a stationary visual acuity (within two Snellens' line). Seven of the 14 patients had final visual acuity less than 0.1.
Conclusion: Photocoagulation and TTT showed similar effect on visual pro-gnosis and subretinal fluid resolution in our case series. Poor post treatment visual acuity was related with tumor or subretinal fluid involving the fovea and poor initial visual acuity. Fifty percent of patients had visual acuity less than 0.1 though the rate of complete subretinal fluid absorption was as high as 71%.

並列關鍵字

choroidal hemangioma ； photocoagulation ； transpupillary thermotherapy