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Intravitreal Injection of Beva Cizumab and Focal Laser Photocoagulation for Choroidal Metastatic Tumors- A Case Report
鞏膜轉移性腫瘤之玻璃體內Bevacizumab注射及局部視網膜雷射治療－病例報告
摘要
目的：報告鞏膜轉移性腫瘤接受玻璃體內bevacizumab注射及局部視網膜雷射治療後最佳矯正視力為20／20。方法：病例報告－一名68歲男性於2006年12月診斷為肺腺瘤（T4N1M0），並接受過手術治療、放射線治療及化學治療。該名病患因為右眼視力模糊於2009年12月至本院眼科門診求診，當時最佳矯正視力為20／40。眼底檢查發現右眼有多處轉移性腫瘤病兆，光學同調斷層掃描檢查顯示黃斑部有視網膜下積水並漿液性剝離。在確定為鞏膜移轉性腫瘤的診斷後，分別對病人進行兩次玻璃體內bevacizumab注射及三次局部視網膜雷射治療。病患經治療並追蹤三個月後最佳矯正視力為20／20。眼底檢查發現病兆處產生疤痕，眼底血管攝影檢查顯示視網膜有多處螢光顯影但無螢光染劑滲漏，光學同調斷層掃描顯示黃斑部積水及漿液性剝離消失。結論：對於鞏膜移轉性腫瘤且想保留視力及生活品質的病患而言，玻璃體內bevacizumab注射合併局部視網膜雷射治療是一個可以考慮的治療選擇。然而這種治療方式仍需長期追蹤其治療效果。
關鍵字
無資料並列摘要
Purpose: We present a case of choroidal metastatic tumors achieving a best corrected visual acuity of 20/20 after intravitreal injection of bevacizumab (Avastin) and focal laser photocoagulation.Method: Interventional case report.Results: A 68 y/o male has been diagnosed with pulmonary adenocarcinoma (T4N1M0) in December 2006, and had received surgical intervention, radiotherapy and chemotherapy. He visited our outpatient department in December 2009 and presented with blurred vision in his right eye. His best corrected visual acuity was 20/40. Fundus examination revealed multiple subretinal masses, light orange in color, superotemporal and inferonasal to the fovea, in the right eye. Optical coherence tomography scan showed marked subretinal fluid of the macula. A diagnosis of choroidal metastasis secondary to lung cancer was made. After discovering choroidal metastatic lesions, two sessions of intravitreal injection of bevacizumab and three sessions of focal laser photocoagulation were performed. After three months follow-up, his best corrected visual acuity regained 20/20. Scarring and flattening of choroidal lesions were noted on color fundus photography. Multiple hyperfluorescent spots without leakage were showed on fluorescein angiography. Regression of macular edema and serous detachment were evident on optical coherence tomography scan.Conclusion: For the patient with choroidal metastases who wants to preserve good visual acuity and better quality of remained life, intravitreal injection of bevacizumab plus focal laser photocoagulation may be considered. Longer follow-up period is needed for evaluation of efficacy and effectiveness of such treatment.
延伸閱讀
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