Neovascularization, Pathologic

新生血管形成,病理性
  • 文章类型: Journal Article
    背景:超声睫状体成形术是一种无创手术,用于降低青光眼患者的眼内压,减少严重并发症。本报告介绍了超声睫状体成形术后的几例虹膜新生血管形成和神经营养性角膜病变。
    方法:6例诊断为难治性青光眼的患者在我们的诊所接受了超声睫状体成形术。3例患者分别于术后第3天、第2周和第4周出现虹膜新生血管,眼压范围从12到24mmHg。其他3例患者在术后第3周,第6周和第8周出现神经营养性角膜病变,并在60天内完全愈合。
    结论:超声睫状体成形术后可引发虹膜新生血管和神经营养性角膜病变,这是不常见的,自我限制,但潜在的视力威胁。建议进行术前风险评估和术后定期随访,以有效控制并发症。
    BACKGROUND: Ultrasound cycloplasty is a noninvasive surgery used to reduce intraocular pressure in patients with glaucoma, with fewer severe complications. This report presents several cases of iris neovascularization and neurotrophic keratopathy following ultrasound cycloplasty.
    METHODS: Six patients diagnosed with refractory glaucoma underwent ultrasound cycloplasty at our clinic. Three cases developed iris neovascularization at postoperative day 3, week 2 and week 4 respectively, with intraocular pressure ranging from 12 to 24 mmHg. The other three cases developed neurotrophic keratopathy at postoperative week 3, week 6 and week 8 which completely healed within 60 days.
    CONCLUSIONS: Iris neovascularization and neurotrophic keratopathy can be triggered after ultrasound cycloplasty, which are uncommon and self-limited but potentially vision-threatening. Preoperative risk assessment and regular postoperative follow-up are recommended to manage complications effectively.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    目的:报告一例26岁男性双侧Eales病,导致左眼完全失明,右眼在短时间内合法失明。方法:临床全身检查,计算机断层扫描,磁共振成像,基因检测,在报告的病例中进行了光学相干断层扫描。结果:眼睛的状况是通过散射激光治疗,抗VEGF注射液,前房穿刺和小梁切除术。非甾体类眼药水,以及前列腺素类似物,β受体阻滞剂,和碳酸酐酶抑制剂,已被用作局部治疗。全身治疗包括静脉注射甲基强的松龙疗程,口服皮质类固醇,硫唑嘌呤,霉酚酸酯和12种抗VEGF注射液的总量。结论:尽管口服类固醇积极治疗,免疫抑制剂,和抗VEGF注射,有很多恶化,并且没有实现缓解。因此,侵袭性新生血管性青光眼,导致左眼完全失明和右眼合法失明。缩写:HLA=人类白细胞抗原,抗VEGF=血管内皮生长因子抑制剂,BCVA=最佳矫正视力,FA=眼底血管造影,HBsAg=乙型肝炎表面抗原,抗HCV=丙型肝炎抗体,TPHA=梅毒螺旋体血凝试验,PCR=聚合酶链反应,HSV=单纯疱疹病毒,VZV=水痘带状疱疹病毒,CMV=巨细胞病毒,IOP=眼内压。
    Purpose: To report the case of a 26-year-old male with bilateral Eales\' disease that led to total blindness in the left eye and legal blindness in the right eye in a short time. Methods: A total clinical systemic examination, computed tomography, magnetic resonance imaging, genetic testing, and optical coherence tomography were performed in the reported case. Results: The eye condition was managed by scatter laser treatment, Anti-VEGF injections, anterior chamber paracentesis and trabeculectomy. Non-steroidal eye drops, as well as prostaglandin analogues, beta-blockers, and carbonic anhydrase inhibitors, have been used as local treatment. Systemic treatment included an intravenous methylprednisolone course, oral corticosteroids, azathioprine, mycophenolate mofetil and a total amount of 12 Anti-VEGF injections. Conclusion: Despite the aggressive treatment with oral steroids, immunosuppressants, and anti-VEGF injections, there were many exacerbations, and remission was not achieved. As a result, aggressive neovascular glaucoma developed, which led to total blindness in the left eye and legal blindness in the right eye. Abbreviations: HLA = human leukocyte antigens, Anti-VEGF = vascular endothelial growth factor inhibitors, BCVA = best corrected visual acuity, FA = fundus angiography, HBsAg = hepatitis B surface antigen, Anti-HCV = hepatitis C antibodies, TPHA = Treponema Pallidum hemagglutination assay, PCR = polymerase chain reaction, HSV = Herpes simplex virus, VZV = Varicella zoster virus, CMV = cytomegalovirus, IOP = intraocular pressure.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    背景:Eales病是一种以视网膜静脉炎为特征的特发性周边视网膜血管病变,缺血,视网膜新生血管,和复发性玻璃体出血。但是CRAO是一个不寻常的演示。
    方法:一名27岁的印度裔健康女护士醒来时右眼突然视力下降。视网膜中央动脉阻塞(CRAO),合并轻度视网膜中央静脉阻塞(CRVO),被诊断出来了.在连续三次高压氧治疗的第二次期间,她的视力迅速提高。一周后,她在同一只眼睛出现了周围性静脉炎。传染性,炎症,血液学病因被排除.除Mantoux结核菌素皮肤试验阳性外,系统评估正常。全身性类固醇治疗后,她的血管炎逐渐好转。两周后,左眼出现轻度视网膜静脉炎。排除其他疾病后诊断为Eales病。
    结论:这是一个不寻常的Eales病病例,表现为CRAO合并轻度CRVO。这里首次报道了CRAO和Eales疾病的关联,以我们最好的知识。
    BACKGROUND: Eales\' disease is an idiopathic peripheral retinal vasculopathy characterized by retinal phlebitis, ischemia, retinal neovascularization, and recurrent vitreous hemorrhages. But CRAO is an unusual presentation.
    METHODS: A 27-year-old healthy female nurse of Indian descent presented with sudden vision loss in her right eye upon awakening. Central retinal artery occlusion (CRAO), combined with mild central retinal vein occlusion (CRVO), was diagnosed. During the second of three consecutive sessions of hyperbaric oxygen treatments, her vision rapidly improved. One week later, she developed peripheral phlebitis in the same eye. Infectious, inflammatory, and hematologic etiologies were excluded. The systemic evaluation was normal except for a positive Mantoux tuberculin skin test. Following systemic steroidal treatment, she experienced gradual improvement of her vasculitis. Two weeks later, mild retinal phlebitis appeared in her left eye. Eales\' disease was diagnosed after the exclusion of other diseases.
    CONCLUSIONS: This is an unusual Eales\' disease case, which presented as combined CRAO with mild CRVO. The association of CRAO and Eales\' disease is reported here for the first time, to our best knowledge.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    背景:Eales病是一种影响中周边视网膜的临床综合征,伴有特发性闭塞性血管炎和随后可能的视网膜新生血管形成。该疾病可发展成视觉威胁的并发症。病例介绍:我们报告了一名40岁的白人男性,有可卡因滥用史,左眼视力模糊(LE)。眼底检查显示玻璃体出血,静脉血管的外周鞘,LE的视网膜新生血管区域,和右眼周围闭塞性静脉炎。除了因子VLeiden的杂合突变外,整个血清学面板均为阴性。临床和生化参数提示诊断为Eales病。用地塞米松治疗,每天每公斤1毫克,在4个月内慢慢减少,和外周激光光凝使临床体征和症状消退。结论:此病例显示与可卡因滥用相关的Eales病的罕见表现。可卡因滥用和血栓形成,作为辅因子,可能在这种视网膜病变的发病途径上使视网膜微循环敏感。此外,鉴于这一假设,在这种情况下,建议眼科医生进行全面的眼科和一般病史,以调查药物滥用和凝血障碍。
    Background: Eales disease is a clinical syndrome affecting the mid-peripheral retina with an idiopathic occlusive vasculitis and possible subsequent retinal neovascularization. The disease can develop into visually threatening complications. Case Presentation: We report the case of a 40-year-old Caucasian male with a history of cocaine abuse who presented with blurred vision in the left eye (LE). Fundus examination showed vitreous hemorrhages, peripheral sheathing of venous blood vessels, areas of retinal neovascularization in the LE, and peripheral occlusive phlebitis in the right eye. The full serologic panel was negative except for the heterozygous mutation of factor V Leiden. Clinical and biochemical parameters suggested a diagnosis of Eales disease. Therapy with dexamethasone, 1 mg per kg per day, tapered down slowly over 4 months, and peripheral laser photocoagulation allowed a regression of clinical signs and symptoms. Conclusion: This case shows an uncommon presentation of Eales disease associated with cocaine abuse. Both cocaine abuse and a thrombophilic pattern, as cofactors, might have sensitized the retinal microcirculation on the pathogenetic route to this retinal pathology. Furthermore, in view of this hypothesis, a thorough ocular and general medical history investigating drug abuse and coagulation disorders is recommended for ophthalmologists in such cases.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Editorial
    在过去的二十年中,多激酶抑制剂的成功开发彻底改变了许多恶性肿瘤的管理。抗血管生成激酶抑制剂索拉非尼等药物具有某些优点,例如对癌细胞具有广谱的活性,血管内皮细胞,和周细胞,并且是晚期肾癌或肝癌等疾病的主要治疗手段。在一些相同的疾病中,使用免疫检查点阻断的免疫治疗的最新出现引发了关于与抗血管生成药物的治疗相互作用的重要问题。七个这样的组合已被批准用于肺部,肝脏,肾,子宫内膜癌,和多种联合疗法在临床上正在积极追求。因此,揭示抗血管生成激酶抑制剂联合免疫检查点阻断的作用机制对于进一步改善治疗结果至关重要.关于索拉非尼在癌症治疗中的具有里程碑意义的评论强调了这些重要问题。参见Wilhelm等人的相关文章。,癌症报告2004;64:7099-109。
    The successful development of multikinase inhibitors over the last two decades has revolutionized the management of many malignant cancers. Agents such as the antiangiogenic kinase inhibitor sorafenib have certain advantages such as a broad spectrum of activity against cancer cells, vascular endothelial cells, and pericytes, and are the mainstay of treatment in diseases such as advanced renal or liver cancer. The more recent emergence of immunotherapy-using immune checkpoint blockade-in some of the same diseases has raised important questions about the treatment interaction with antiangiogenic drugs, seven such combinations have been approved for lung, liver, kidney, and endometrial cancers, and multiple combination therapies are being aggressively pursued in the clinic. Thus, revealing mechanisms of action of antiangiogenic kinase inhibitors in combination with immune checkpoint blockade is critical to improving the treatment outcome further. This Landmark commentary on sorafenib in cancer therapy highlights these important questions. See related article by Wilhelm et al., Cancer Res 2004;64:7099-109.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    以新生血管形成为特征的缺血性视网膜病变可由几种疾病引起,如增殖性糖尿病视网膜病变,高血压视网膜病变,和视网膜静脉阻塞.然而,由红细胞增多症引起的眼部缺血性疾病很少被描述.我们报告了一名41岁的男性重度吸烟者的第一例与红细胞增多症相关的增生性缺血性视网膜病变,该患者因继发性红细胞增多症而患有眼部缺血性疾病。他的右眼视力突然丧失,玻璃体出血和弯曲的视网膜动脉。追溯到他的历史,30多年来,他一直是个烟鬼,每天吸烟不止一包。实验室数据显示血红蛋白水平(17.7g/dL)和血细胞比容(51.6%)升高,无其他异常发现。我们在新生血管区域和纤维膜上进行了视网膜光凝。此外,建议病人戒烟。由于坚持这种治疗,患者的视力逐渐恢复。虽然罕见,红细胞增多症可引起视网膜缺血事件,应被视为一种威胁视力的疾病.光凝对新生血管病变的消退有效。最重要的是,生活方式的改变和戒烟对控制继发性红细胞增多症有效.总之,预防和停止烟草消费有助于改善视力健康。
    Ischemic retinopathy characterized by neovascularization could result from several diseases such as proliferative diabetic retinopathy, hypertensive retinopathy, and retinal vein occlusion. However, ocular ischemic conditions caused by polycythemia have rarely been described. We report the first case of polycythemia-related proliferative ischemic retinopathy in a 41-year-old male heavy smoker who had ocular ischemic condition due to secondary polycythemia. He had sudden loss of vision in his right eye vision with vitreous hemorrhage and a tortuous retinal artery. Tracing back to his history, he was a heavy smoker with more than one pack of cigarettes per day for more than 30 years. Laboratory data revealed elevated levels of hemoglobin (17.7 g/dL) and hematocrit (51.6%) without other abnormal findings. We performed retinal photocoagulation on the neovascular areas and the fibrous membrane. Additionally, the patient was advised to quit smoking. Owing to adherence to this treatment, the patient\'s vision gradually recovered. Although rare, polycythemia can cause retinal ischemic events and should be considered as a sight-threatening disease. Photocoagulation is effective on the regression of the neovascular lesion. Most importantly, changes in lifestyle together with smoking cessation are effective in managing secondary polycythemia. In conclusion, prevention and cessation of tobacco consumption helps improve vision health.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Review
    目的:本病例报告描述了一个健康的12岁女孩的视网膜中央静脉阻塞(CRVO),该女孩在24岁时出现了视网膜新生血管。据我们所知,这是报告的儿科CRVO事件与新生血管形成之间的最长时间.
    方法:患者有完整的病史,体检,和实验室检查以确定导致血管事件的潜在危险因素。眼底照片,在患者的整个治疗过程中进行光学相干断层扫描和荧光素血管造影。
    结果:家族史为非缴费型,但实验室检测显示亚甲基四氢叶酸还原酶中的同型半胱氨酸水平轻度升高和纯合C677T突变.因此,她开始补充叶酸。迄今为止,患者没有进一步的眼部或全身血栓形成事件。
    结论:出现CRVO的儿科患者应进行全身检查,并需要长期随访以避免并发症,如眼内出血,牵引性视网膜脱离,和新生血管性青光眼。
    OBJECTIVE: This case report describes a central retinal vein occlusion in a healthy 12-year-old girl who developed retinal neovascularization at 24 years of age. To the knowledge of the authors, this is the longest time between a reported pediatric central retinal vein occlusion event and neovascularization.
    METHODS: The patient underwent a full history, physical examination, and laboratory workup to determine potential risk factors contributing to the vascular event. Fundus photographs, optical coherence tomography, and fluorescein angiography were performed throughout the patient\'s treatment course.
    RESULTS: Family history was noncontributory, but laboratory testing revealed a mildly elevated homocysteine level and homozygous C677T mutation in methylenetetrahydrofolate reductase. As a result, she was started on folate supplementation. The patient has had no further ocular or systemic thrombotic events to date.
    CONCLUSIONS: Pediatric patients presenting with central retinal vein occlusion should undergo a systemic workup and require long-term follow-up to avoid complications, such as intraocular hemorrhage, tractional retinal detachments, and neovascular glaucoma.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    本研究旨在证明使用抗VEGF注射和氩激光光凝联合治疗角膜新生血管的可能性。
    The present study aimed to demonstrate the possibility to treat corneal neovascularization using the combination of anti-VEGF injection and argon laser photocoagulation.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    描述动静脉畸形(AVM)和增强的子宫肌层血管(EMV)的病因,并通过病例介绍回顾与EMV相关的保留妊娠产物(RPOC)患者的管理更新。
    一段6分钟的叙述视频讨论了EMV和AVM之间最近的区别。病因,症状,成像发现/解释,和基于症状的管理进行了详细的审查。因为这代表一个病例报告,根据45CFR46.102(l)的规定,它不符合研究的定义;因此,不需要机构审查委员会的批准。
    三级转诊中心。
    不完全流产后8周,一名28岁的gravida1,para0患者被带到RPOC的外部设施,月经过多,和血红蛋白的急剧减少。确诊子宫AVM后,她被转移到我们的机构接受进一步的治疗.
    转移到我们中心后,超声显示RPOC,有明显的内部脉管系统,收缩期峰值速度>20cm/s。诊断为EMV。磁共振成像证实子宫内膜和子宫腔内RPOC有明显的蛇形血管(图1).由于她的贫血,她接受了子宫动脉栓塞术(UAE),然后进行抽吸D&C(图。2).宫腔镜检查在吸痰前后和刮宫后进行,子宫内膜表面有一个大的维管束。
    无。
    患者在术后2周时出现异常子宫出血症状和β-人绒毛膜促性腺激素试验阴性。
    EMV患者的治疗取决于其症状的程度。如果出现明显出血,需要手术管理。先前的报告表明,EMV和RPOC患者应在D&C之前接受UAE,但是最近的研究表明,D&C可能在没有阿联酋的情况下启动,因为与RPOC相关的EMV可能是一种正常的一过性胎盘形成现象,并且出血风险比以前怀疑的要低。然而,术前明显出血和/或贫血的患者,我们建议阿联酋仍然应该被考虑。每个患者都需要根据症状进行个性化管理,标志,成像,以及未来生育计划。RPOC和EMV患者的理想管理仍有待确定。
    To describe the etiology of arteriovenous malformations (AVM) and enhanced myometrial vascularity (EMV), and review updates in management for patients with retained products of conception (RPOC) associated with EMV through a case presentation.
    A 6-minute narrated video discusses the recent distinction between EMV and AVM. The etiology, symptoms, imaging findings/interpretation, and management based on symptoms are reviewed in detail. As this represents a single case report, it does not meet the definition of research according to the regulations at 45 CFR 46.102(l); therefore, institutional review board approval was not required.
    Tertiary referral center.
    Eight weeks after suction dilation and curettage (D&C) for an incomplete abortion, a 28-year-old gravida 1, para 0 patient presented to an outside facility with RPOC, menorrhagia, and an acute decrease in hemoglobin. After uterine AVM was diagnosed, she was transferred to our facility for further care.
    After transfer to our center, ultrasound demonstrated RPOC, with prominent internal vasculature containing peak systolic velocity >20 cm/s. A diagnosis of EMV was made. Magnetic resonance imaging confirmed a prominent serpentine vessel at the endometrium and RPOC within the uterine cavity (Fig. 1). Due to her anemia, she underwent uterine artery embolization (UAE) followed by suction D&C (Fig. 2). Hysteroscopy was performed before and after suction D&C and after curettage, a large vascular bundle was appreciated at the surface of the endometrium.
    None.
    The patient presented to the clinic 2 weeks postoperatively with the resolution of abnormal uterine bleeding symptoms and a negative β-human chorionic gonadotropin test.
    Management of patients with EMV is dependent on the extent of their symptoms. If significant bleeding is present, surgical management is required. Previous reports suggested that patients with EMV and RPOC should undergo UAE before D&C, but more recent studies suggest that D&C may be initiated without UAE, as EMV associated with RPOC may be a normal transient placentation phenomenon and have less risk of hemorrhage than previously suspected. However, in patients with significant preoperative bleeding and/or anemia, we propose that UAE should still be considered. Each patient requires individualized management based on symptoms, signs, imaging, and plans for future fertility. The ideal management of patients with RPOC and EMV remains to be determined.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Case Reports
    背景:肿瘤向眼部的转移并不常见。在这个案例报告中,我们描述了一名患者,其中通过虹膜肿瘤的细针穿刺活检(FNAB)诊断为原发性食道癌。
    方法:一名70岁男性主诉右眼发红和不适。
    方法:患者的右眼被诊断为特发性葡萄膜炎,并给予局部类固醇。由于即使在局部治疗后也观察到玻璃体混浊,口服泼尼松龙。在右眼的裂隙灯检查中,在前房可见虹膜肿块伴新生血管形成.怀疑有转移性肿瘤,进行了FNAB。组织学显示鳞状细胞癌。全身检查显示食道癌有几个转移。最佳矫正视力降至20/400,右眼眼压为40mmHg。存在两个具有新生血管形成的虹膜肿瘤,并延伸到前房,并伴有虹膜后粘连和360度周围前粘连。右眼的眼压通过低血压滴眼液和口服乙酰唑胺进行医学管理。虹膜转移瘤采用40Gray放疗和同步化疗治疗。
    结果:肿瘤消退,但由于360度房角粘连闭合,眼压难以治疗。治疗开始六个月后,右眼失去了光知觉,患者在治疗开始9个月后因多发性全身转移而死亡。
    结论:这是一例罕见的假扮综合征,没有全身症状,虹膜肿瘤的FNAB导致转移性食管鳞状细胞癌的诊断。尽管患者由于无法控制的高眼压而失明,全身化疗,和放射治疗最初对转移性虹膜肿瘤的治疗有效。由于转移性虹膜肿瘤患者的预后较差,眼科医生必须考虑此类诊断,并在必要时进行系统性检查。
    BACKGROUND: Metastasis of neoplasms to the eye is quite uncommon. In this case report, we describe a patient where primary esophageal cancer was diagnosed by fine needle aspiration biopsy (FNAB) of an iris tumor.
    METHODS: A 70-year-old male complained of redness and discomfort in the right eye.
    METHODS: The patient\'s right eye was diagnosed as idiopathic uveitis, and a topical steroid was administered. As vitreous opacities were observed even after topical therapy, oral prednisolone was administered. On slit-lamp examination of the right eye, an iris mass with neovascularization was seen in the anterior chamber. A metastatic tumor was suspected, and FNAB was performed. Histology revealed squamous cell carcinoma. Systemic workup revealed esophageal cancer with several metastases. Best-corrected visual acuity decreased to 20/400, and intraocular pressure was 40 mmHg in the right eye. Two iris tumors with neovascularization were present extending into the anterior chamber with posterior iris synechiae and 360 degree peripheral anterior synechiae. Intraocular pressure in the right eye was medically managed with hypotensive eye drops and oral acetazolamide. Iris metastases were treated with 40 Gray of radiation therapy and concurrent chemotherapy.
    RESULTS: The tumor regressed, but intraocular pressure was refractory to treatment because of 360 degree goniosynechial closure. The right eye lost light perception six months after treatment commenced, and the patient died 9 months after the onset of therapy due to multiple systemic metastases.
    CONCLUSIONS: This is a rare case of masquerade syndrome without systemic symptoms in which FNAB of an iris tumor led to a diagnosis of metastatic esophageal squamous cell carcinoma. Although the patient lost his sight due to uncontrollable ocular hypertension, systemic chemotherapy, and radiation therapy were initially effective in the treatment of the metastatic iris tumor. As the prognosis of patients with metastatic iris tumors is poor, it is important for ophthalmologists to consider such diagnoses and conduct systemic investigations when necessary.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号