Circumscribed Choroidal Hemangioma in a Chinese Patient Treated Using Transpupillary Thermotherapy: A Case Report

本文敘述正式文獻報告中，第一例華人罹患脈絡膜血管瘤，以經瞳孔熱療法成功治療。一位57歲男性在左眼被發現有滲出性黃斑部剝離，且在視神經盤上方有一凸出、橘紅色、5×5釐米大小之視網膜下腫塊，超音波顯示厚度為3釐米及高度內反射性，螢光眼底攝影可見早期有螢光滲漏，因此診斷為脈絡膜血管瘤，並安排經瞳孔熱療法治療，方法是以二極體雷射裝置於細隙燈上，雷射點直徑為3釐米，時間為1分鐘，雷射能量自300毫瓦開始，並以50毫瓦慢慢增加，在週邊視網膜作測試，直到雷射照射區域稍灰白為止，腫瘤以4個重疊之雷射點照射，平均之雷射能量為400毫瓦，病患之最佳矯正視力自治療前20/50，經過一次治療，三個月後進步至20/20，病灶萎縮且視網膜下液體也消失，我們的經驗顯示，以經瞳孔熱療法治療脈絡膜血管瘤，對亞洲人之療效可能比白種人更好，經瞳孔熱療法之雷射能量，中國人應比白種人低。

關鍵字

局限性脈絡膜血管瘤；經瞳孔熱療法；二極體雷射；眼底色素

並列摘要

We describe the first case of a Chinese patient with circumscribed choroidal hemangioma (CCH) effectively managed using transpupillary thermotherapy (TTT). A 57-year-old man had an elevated orange-red subretinal mass with a base of 5×5 mm superior to the optic disc, along with serous macular detachment in the left eye. Ultrasonography depicted a mass 3 mm thick with acoustic solidity and high internal reflectivity. Fluorescein angiography showed an area of hyperfluorescence in the prearterial phase and tumor staining in the late phase, consistent with a diagnosis of CCH. Therefore, TTT (spot size, 3 mm; exposure, 1 min) was performed with a diode laser, delivered through a slit-lamp biomicroscope. The laser power was first set at 300 mW and then increased in 50-mW increments, until test shots in the mid-peripheral retina outside the lesion produced a slightly grayish appearance in the irradiated area. The tumor was covered with four overlapping laser spots and subjected to an average beam power of 400 mW. Best-corrected visual acuity increased from 20/50 before treatment, to 20/20 3 months following one session of TTT. The lesion became atrophic and the subretinal fluid disappeared. Our experience shows that TTT can be an even more effective treatment strategy for CCH in Asians than in Caucasians. In Chinese patients, the power level of the diode laser should be lower than that used in Caucasians.

並列關鍵字

circumscribed choroidal hemangioma ； diode laser ； fundus pigmentation ； transpupillary thermotherapy

國際替代計量

Circumscribed Choroidal Hemangioma in a Chinese Patient Treated Using Transpupillary Thermotherapy: A Case Report

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