Effect of prolonged photodynamic therapy irradiation time combined with intravitreal injection of ranibizumab in the treatment of circumscribed choroidal hemangioma

Q4 Medicine

中华眼底病杂志 Pub Date : 2020-02-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2020.02.006

Siying Liang, Qingshan Chen, Chenli Hu, Zhi Li

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引用次数: 0

Abstract

Objective To observe the clinical effect of prolonged photodynamic therapy (PDT) irradiation time combined with intravitreal injection of ranibizumab in the treatment of circumscribed choroidal hemangioma (CCH). Methods A retrospective clinical study. From March 2012 to March 2018, 51 eyes of 51 patients diagnosed in Shenzhen Eye Hospital were included in the study. Among the patients, the tumor of 36 eyes were located in macular area, of 15 eyes were located outside macular area (near center or around optic disc). All patients underwent BCVA, color fundus photography, FFA, ocular B-scan ultrasonography and OCT examinations. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. OCT showed 48 eyes with macular serous retinal detachment. of 36 eyes with tumor located in macular area, the logMAR BCVA was 0.05±0.05, the tumor thickness was 4.5± 2.2 mm, the diameter of tumor was 9.7±3.6 mm. Of 15 eyes with tumor located outside macular area, the logMAR BCVA was 0.32±0.15, the tumor thickness was 3.8±1.4 mm, the diameter of tumor was 7.7± 1.9 mm. PDT was performed for all eyes with the irradiation time of 123 s. After 48 h, all patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml). At 1, 3 and 6 months after treatment, the same equipment and methods before treatment were used for related examination. BCVA, subretinal effusion (SRF), tumor leakage and size changes were observed. BCVA, tumor thickness and diameter before and after treatment were compared by t test. Results At 6 months after treatment, the tumor was becoming smaller without scar formation. FFA showed that the blood vessels in the tumor were sparse compared with those before treatment, and the fluorescence leakage domain was reduced. OCT showed 43 eyes of macular serous detachment were treated after the combined treatment. The logMAR BCVA were 0.16±0.15 and 0.55±0.21 of the eyes with tumor located in or outside macular area, respectively. The difference of logMAR BCVA between before and after treatment was significant (t=-2.511, -2.676; P=0.036, 0.040). Both the tumor thickness (t=3.416, 3.055; P=0.011, 0.028) and diameter (t=4.385, 4.171; P=0.002, 0.009) of CCH patients were significantly reduced compared with that before treatment. Conclusion The tumor of CCH can be reduced by prolonged PDT irradiation time combined with intravitreal injection of ranibizumab. Key words: Photochemotherapy; Choroid neoplasms/therapy; Hemangioma/therapy; Angiogenesis inhibitors/therapeutic use

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延长光动力治疗照射时间联合玻璃体内注射雷尼单抗治疗局限性脉络膜血管瘤的效果

目的观察延长光动力治疗(PDT)照射时间联合玻璃体内注射雷尼单抗治疗局限性脉络膜血管瘤(CCH)的临床疗效。方法回顾性临床研究。2012年3月至2018年3月，在深圳眼科医院诊断的51例患者的51只眼睛被纳入研究。其中36眼肿瘤位于黄斑区，15眼肿瘤位于黄斑区外(近中心或视盘周围)。所有患者均行BCVA、眼底彩色摄影、FFA、眼b超及OCT检查。BCVA检查采用国际标准视力表，视力表转换为logMAR视力。OCT显示48眼黄斑浆液性视网膜脱离。肿瘤位于黄斑区36眼，logMAR BCVA为0.05±0.05，肿瘤厚度为4.5±2.2 mm，肿瘤直径为9.7±3.6 mm。肿瘤位于黄斑区外15眼，logMAR BCVA为0.32±0.15，肿瘤厚度为3.8±1.4 mm，肿瘤直径为7.7±1.9 mm。全眼行PDT，照射时间123s。48 h后，所有患者接受玻璃体内注射0.5 mg雷尼单抗(0.05 ml)。治疗后1、3、6个月，采用治疗前相同的设备和方法进行相关检查。观察BCVA、视网膜下积液(SRF)、肿瘤渗漏及大小变化。治疗前后BCVA、肿瘤厚度、直径比较采用t检验。结果治疗6个月后，肿瘤逐渐缩小，无瘢痕形成。FFA显示肿瘤内血管较治疗前稀疏，荧光漏域减小。OCT显示43眼黄斑浆液性脱离经联合治疗。肿瘤位于黄斑区内或黄斑区外的眼的logMAR BCVA分别为0.16±0.15和0.55±0.21。治疗前后logMAR BCVA差异有统计学意义(t=-2.511， -2.676;P = 0.036, 0.040)。肿瘤厚度(t=3.416, 3.055;P=0.011, 0.028)和直径(t=4.385, 4.171;P=0.002, 0.009)，与治疗前相比显著降低。结论延长PDT照射时间并联合玻璃体内注射雷尼单抗可减少CCH肿瘤。关键词:光化学疗法;脉络膜肿瘤/治疗;血管瘤/治疗;血管生成抑制剂/治疗用途

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).