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国产敷贴器治疗合并严重渗出性视网膜脱离的Sturge-Weber综合征的临床观察

刘月明  延艳妮  李洋  魏文斌   

  1. 100730 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼内肿瘤诊治研究北京市重点实验室 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2018-06-29 出版日期:2019-03-25 发布日期:2019-03-28
  • 通讯作者: 魏文斌,Email:weiwenbintr@163.com
  • 基金资助:

    北京市医院管理局“登峰”人才培养计划(DF20150201);北京市自然科学基金(7151003);北京市卫生系统高层次卫生技术人才培养计划(2014-2-003);首都卫生发展科研专项项目(首发2016-1-2051)

Clinical observation on the treatment of Sturge-Weber syndrome with severe exudative retinal detachment using domestic radioactive applicator

 LIU Yue-ming, YAN Yan-ni, LI Yang, WEI Wen-bin   

  1.  Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University,  Beijing 100730, China
  • Received:2018-06-29 Online:2019-03-25 Published:2019-03-28
  • Contact: WEI Wen-bin, Email: weiwenbintr@163.com

摘要:

目的 评价国产敷贴器治疗Sturge-Weber综合征弥漫性脉络膜血管瘤继发的渗出性视网膜脱离的临床疗效。设计 回顾性病例系列。研究对象 2009年6月至2018年6月北京同仁医院由临床和影像学诊断为弥漫性脉络膜血管瘤的Sturge-Weber综合征患者15例,均存在渗出性视网膜脱离,均经国产敷贴器进行巩膜外敷贴放射治疗。方法 记录患者治疗前后视力、眼压,彩色超声多普勒(CDI)测量瘤体大小(最大基底直径,最大高度),间接眼底镜,CDI及OCT下观察视网膜下液情况。采用SPSS 22.0对结果进行分析。主要指标 视力、眼压、肿瘤大小,视网膜下液吸收情况及有无并发症发生。结果 15例患者平均随访48个月,末次随访与术前比较,视力提高(P<0.01)(术前0.01±0.02,末次随访0.05±0.11)。眼压无明显变化(P=0.132)(术前19.9±12.1 mmHg,末次随访15.6±2.4 mmHg)。术前瘤体最大基底直径(16.0±3.2)mm,术后末次随访(13.9±3.9)mm(P<0.01);术前瘤体最大高度(6.5±2.0)mm,术后末次随访(2.7±1.5) mm(P<0.01)。15例患者在末次随访时14例视网膜下液完全吸收,1例视网膜下液减少。结论 国产敷贴器巩膜外敷贴放疗治疗Sturge-Weber综合征弥漫性脉络膜血管瘤继发的渗出性视网膜脱离是一种有效的方法。(眼科,2019, 28: 125-128)

关键词:  , Sturge-Weber综合征, 脉络膜血管瘤, 敷贴放射治疗, 放射性125I

Abstract:

 Objective To observe the safety and efficacy of domestic radioactive applicator for treatment of Sturge-Weber syndrome with exudative retinal detachment. Design Retrospective study. Participants 15 patients of Sturge-Weber syndrome with exudative retinal detachment that were treated with domestic radioactive applicator in Beijing Tongren Hospital from June 2009 to June 2018. Methods We recorded the data of visual acuity, intraocular pressure, size of the tumor(maximum base diameter, maximum height) measured by color Doppler imaging (CDI), changes in the subretinal fluid observed by indirect ophthalmoscope, CDI and OCT, and the data were retrospectively analyzed using SPSS 22.0. Main Outcome Measures Visual acuity, intraocular pressure, size of the tumor, changes in the subretinal fluid, occurrence rates of complications. Results Visual acuity significantly improved at latest follow-up (average follow-up was 48 months) (pre-operation 0.01±0.02, latest follow-up 0.05±0.11,P<0.01). Intraocular pressure remained similar (pre-operation19.9±12.1 mmHg, latest follow-up 15.6±2.4 mmHg,P=0.132). Tumor regressed in all cases (maximum basal diameter, pre-operation 16.0±3.2 mm, latest follow-up 13.9±3.9 mm, P<0.01; maximum height, pre-operation 6.5±2.0 mm, latest follow-up 2.7±1.5 mm, P<0.01). No subretinal fluid was observed by indirect ophthalmoscope, CDI or OCT at the latest follow-up except for 1 case. Conclusion It seems to be a good choice to treat the Sturge-Weber syndrome with severe exudative retinal detachment by domestic radioactive applicator. (Ophthalmol CHN, 2019, 28: 125-128)

Key words:  Sturge-Weber syndrome, choroidal hemangioma, plaque radiotherapy, Iodine125