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目的分析视网膜血管增生性肿瘤(VTR)的临床特征,初步探讨其治疗方法。方法回顾性分析经眼底检查、荧光素眼底血管造影(FFA)及B型超声检查确诊的VTR患者17例17只眼的临床资料。其中,1例患者行光动力治疗(PDT),7例患者行视网膜激光光凝治疗。1例患者行玻璃体切割手术时发现VTR予以病理检查和病灶部位激光光凝治疗。结果17例患者17只眼眼底均有单个或多个黄色或红色肿瘤样病变,均同时伴有视网膜内或视网膜下渗出,占100%;伴出血者10只眼,占58.82%;伴视网膜脱离者5只眼,占29.41%。渗出累及黄斑区者9只眼,占52.94%;合并玻璃体积血1只眼,占5.88%。肿瘤位于颞下象限者8只眼,占47.06%;位于颞上象限者7只眼,占41.18%;鼻上下象限各1只眼,分别占5.98%。B型超声检查显示16只眼肿瘤位于视网膜上。FFA检查发现瘤体血管早期即发生明显的荧光素渗漏。1例患者经PDT治疗后肿瘤明显缩小;7例激光光凝的患者中,2例肿瘤缩小,1例渗出减少。结论VTR的临床特征是眼底黄色或红色肿瘤样病变伴视网膜内或视网膜下渗出,B型超声和FFA检查有助于确诊。PDT和激光光凝治疗对控制病变有效,但对视力提高无明显帮助。
Objective To analyze the clinical features of retinal vascular proliferative neoplasm (VTR) and to explore its treatment method. Methods The clinical data of 17 eyes of 17 patients with VTR diagnosed by fundus examination, fluorescein fundus angiography (FFA) and type B ultrasound examination were retrospectively analyzed. Among them, one patient underwent photodynamic therapy (PDT) and seven patients underwent retinal laser photocoagulation. One patient underwent vitrectomy and found that the VTR was given pathological examination and laser photocoagulation of the lesion site. Results Seventeen eyes of 17 patients had single or multiple yellow or red tumor-like lesions in the fundus, both with or without retinal exudate (100%), 10 eyes with bleeding (58.82%), retinal 5 eyes, accounting for 29.41%. Exudation involving the macular area in 9 eyes, accounting for 52.94%; combined vitreous hemorrhage in 1 eye, accounting for 5.88%. The tumor located in the inferior temporal quadrant of 8 eyes, accounting for 47.06%; located in the superior temporal quadrant of 7 eyes, accounting for 41.18%; nasal up and down the quadrant of 1 eye, accounting for 5.98%. B-mode ultrasound revealed that 16 ocular tumors were located on the retina. FFA examination found that tumor vessels early significant fluorescein leakage occurred. One patient had a significantly smaller tumor after treatment with PDT. Of the seven patients with laser photocoagulation, two had a smaller tumor and one had less exudation. Conclusions The clinical features of VTR are yellow or red tumor-like lesions in the fundus with or without intra-retinal or subretinal exudation. Type B ultrasound and FFA may be helpful in diagnosis. PDT and laser photocoagulation treatment of lesions effective, but no significant improvement in vision help.