AIM: To compare the efficacy and safety of photodynamic therapy(PDT) with overlapping multiple spots and single spot for treating circumscribed choroidal hemangioma. · METHODS: Twenty-two patients(22 eyes) with s...AIM: To compare the efficacy and safety of photodynamic therapy(PDT) with overlapping multiple spots and single spot for treating circumscribed choroidal hemangioma. · METHODS: Twenty-two patients(22 eyes) with symptomatic circumscribed choroidal hemangioma received PDT treatment. Fourteen patients received overlapping spots(two to three spots) PDT,whereas eight patients received single-spot PDT. Laser was used at 50J/cm2for 83s in the overlapping-spot group and 50J/cm2for 166s in the single-spot group. Clinical examination,funduscopy,fluorescein angiography,and ultrasonography were performed at baseline and after treatment. ·RESULTS: The mean follow-up time was 28.5 ±8.0 months in the overlapping-spot group and 27.0 ±5.0 months in the single-spot group. Nine patients(64.2%) had their vision improved over two lines on the Snellen chart,and five patients showed stable visual acuity in the overlapping-spot group. The mean thickness of tumor decreased from 2.7 ±0.8mm to 1.2±0.9mm,and the mean greatest tumor linear dimension decreased from 7.4 ± 1.5mm to 4.5 ±3.5mm after treatment. In the single-spot group,two patients(25%) had their vision improved over two lines on the Snellen chart,and six patients had unchanged stable vision. The mean tumor thickness in this group decreased from 2.5±0.7mm to 1.4±1.0mm,and the mean greatest tumor linear dimension decreased from 7.2±1.3mm to 4.7±3.6mm. No significant differences in visual improvement and tumor regression were found between the two groups. ·CONCLUSION:Overlapping-spotPDTunderappropriate treatment parameters and strategies is as effective andsafe as single-spot PDT for treating symptomatic circumscribed choroidal hemangioma. Improved or stabilized visual acuity was achieved as a result of tumor regression.展开更多
AIM:To evaluate the efficacy and safety of ruthenium-106(106Ru)plaque radiotherapy at a dose(>50 Gy)higher than recommended(29-50 Gy)for treatment of circumscribed choroidal hemangioma(CCH)in Chinese patients.METHO...AIM:To evaluate the efficacy and safety of ruthenium-106(106Ru)plaque radiotherapy at a dose(>50 Gy)higher than recommended(29-50 Gy)for treatment of circumscribed choroidal hemangioma(CCH)in Chinese patients.METHODS:This retrospective study included 25symptomatic CCH patients undergoing 106Ru plaque brachytherapy involving 25 eyes between January 2005and August 2016.Ophthalmic examination was performed at the baseline and at each post-treatment follow-up visit,using best-corrected visual acuity(BCVA),dilated fundus examination,and B-scan ultrasonography.The primary efficacy outcome measures included the changes in BCVA and hemangioma dimensions at the last followup visit from the baseline.RESULTS:The mean follow-up duration was 28.0±26.6(range,12-110)mo.All the hemangiomas were located in the posterior pole except for two involving the fovea.The mean apex dose of 106Ru plaque radiotherapy was84.4±19.7 Gy.The mean BCVA improved from 41.4±29.3(0-97)at the baseline to 53.0±33.8(0-97)ETDRS letters at the last visit(P=0.01).The mean hemangioma height declined from 3.98±0.88(2.40-5.50)mm to 0.84±1.63(0-6.47)mm(P≤0.001),and the greatest linear diameter(GLD)reduced from 9.36±2.23(6.80-15.00)to 7.40±2.45(0-13.00)mm(P≤0.001).Hemangioma size increased in one(4%)eye with a worsened vision,and subretinal fluid completely resolved in all but one patient(4%).Radiationrelated retinopathy was observed in two patients at posttreatment 9 and 11mo,respectively.CONCLUSION:106Ru plaque brachytherapy at a dose(>50 Gy)higher than recommended(29-50 Gy)is an effective treatment regimen for symptomatic CCH associated with significantly improved visual acuity and a favorable safety profile in Chinese patients.展开更多
基金Supported by the Zhejiang Medical Science Research Foundation of China(No.2009A108)Zhejiang Key Innovation Team Project of China(No.2011R09039-02)Zhejiang Key Laboratory Fund of China(No.2011E10006)
文摘AIM: To compare the efficacy and safety of photodynamic therapy(PDT) with overlapping multiple spots and single spot for treating circumscribed choroidal hemangioma. · METHODS: Twenty-two patients(22 eyes) with symptomatic circumscribed choroidal hemangioma received PDT treatment. Fourteen patients received overlapping spots(two to three spots) PDT,whereas eight patients received single-spot PDT. Laser was used at 50J/cm2for 83s in the overlapping-spot group and 50J/cm2for 166s in the single-spot group. Clinical examination,funduscopy,fluorescein angiography,and ultrasonography were performed at baseline and after treatment. ·RESULTS: The mean follow-up time was 28.5 ±8.0 months in the overlapping-spot group and 27.0 ±5.0 months in the single-spot group. Nine patients(64.2%) had their vision improved over two lines on the Snellen chart,and five patients showed stable visual acuity in the overlapping-spot group. The mean thickness of tumor decreased from 2.7 ±0.8mm to 1.2±0.9mm,and the mean greatest tumor linear dimension decreased from 7.4 ± 1.5mm to 4.5 ±3.5mm after treatment. In the single-spot group,two patients(25%) had their vision improved over two lines on the Snellen chart,and six patients had unchanged stable vision. The mean tumor thickness in this group decreased from 2.5±0.7mm to 1.4±1.0mm,and the mean greatest tumor linear dimension decreased from 7.2±1.3mm to 4.7±3.6mm. No significant differences in visual improvement and tumor regression were found between the two groups. ·CONCLUSION:Overlapping-spotPDTunderappropriate treatment parameters and strategies is as effective andsafe as single-spot PDT for treating symptomatic circumscribed choroidal hemangioma. Improved or stabilized visual acuity was achieved as a result of tumor regression.
文摘AIM:To evaluate the efficacy and safety of ruthenium-106(106Ru)plaque radiotherapy at a dose(>50 Gy)higher than recommended(29-50 Gy)for treatment of circumscribed choroidal hemangioma(CCH)in Chinese patients.METHODS:This retrospective study included 25symptomatic CCH patients undergoing 106Ru plaque brachytherapy involving 25 eyes between January 2005and August 2016.Ophthalmic examination was performed at the baseline and at each post-treatment follow-up visit,using best-corrected visual acuity(BCVA),dilated fundus examination,and B-scan ultrasonography.The primary efficacy outcome measures included the changes in BCVA and hemangioma dimensions at the last followup visit from the baseline.RESULTS:The mean follow-up duration was 28.0±26.6(range,12-110)mo.All the hemangiomas were located in the posterior pole except for two involving the fovea.The mean apex dose of 106Ru plaque radiotherapy was84.4±19.7 Gy.The mean BCVA improved from 41.4±29.3(0-97)at the baseline to 53.0±33.8(0-97)ETDRS letters at the last visit(P=0.01).The mean hemangioma height declined from 3.98±0.88(2.40-5.50)mm to 0.84±1.63(0-6.47)mm(P≤0.001),and the greatest linear diameter(GLD)reduced from 9.36±2.23(6.80-15.00)to 7.40±2.45(0-13.00)mm(P≤0.001).Hemangioma size increased in one(4%)eye with a worsened vision,and subretinal fluid completely resolved in all but one patient(4%).Radiationrelated retinopathy was observed in two patients at posttreatment 9 and 11mo,respectively.CONCLUSION:106Ru plaque brachytherapy at a dose(>50 Gy)higher than recommended(29-50 Gy)is an effective treatment regimen for symptomatic CCH associated with significantly improved visual acuity and a favorable safety profile in Chinese patients.
文摘目的探讨孤立性脉络膜血管瘤共焦激光扫描眼底血管造影的影像学特征及其临床意义。方法采用海德堡HRA2共焦激光扫描血管造影系统对21例21只眼孤立性脉络膜血管瘤进行眼底血管造影检查,其中12例行荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查,9例行FFA和吲哚菁绿血管造影(indocyanine green angiography,ICGA)同步检查,分析比较孤立性脉络膜血管瘤2种检查的影像学特征。结果FFA检查动脉前期或动脉早期血管丛状或斑状强荧光,静脉期强荧光灶明显渗漏融合,晚期瘤体呈弥漫性强荧光。6例瘤体表面有明显的不规则点片状弱荧光,13例瘤体表面及周围视网膜毛细血管扩张。10例可见与视网膜色素上皮带状萎缩相应的透见荧光。ICGA检查影像特征为早期瘤体由不规则网状血管团样强荧光,中期瘤体呈强荧光团,晚期所有病例均有特征性的"冲洗现象"。FFA和ICGA同步检查同屏显示,成像清晰,有可比性,ICGA比FFA更清晰显示瘤体范围。结论孤立性脉络膜血管瘤ICGA影像比FFA更具有特征性,并能清晰显示肿瘤大小边界;FFA则可清晰显示视网膜血管及视网膜色素上皮的继发性损伤。激光扫描FFA和ICGA同步检查可为孤立性脉络膜血管瘤诊断、治疗及疗效监测提供更多的临床信息。
