封闭式脉络膜血管瘤是罕见的良性肿瘤,但通常具有进行性病程,并伴有视网膜脱离和青光眼。最近报道了外部辐射对难以用光动力疗法治疗的大型肿瘤的有效性;然而,很少有研究进行长期随访。我们遇到一例局部脉络膜血管瘤,用质子束治疗,随访15年。一名37岁的男子被诊断为10×4mm的脉络膜血管瘤,累及黄斑区并伴有视网膜脱离。质子束治疗在8个部分中以26.4Gy的相对生物有效性(RBE)进行。脉络膜血管瘤在三年内逐渐缩小,视网膜脱离也有所改善。照射11年后患侧发生白内障,照射后15年出现了眼睛协调问题。在随访期间未观察到青光眼;然而,视力没有恢复,病人产生了光感。虽然视力没有保留,质子束治疗可有效缩小肿瘤并维持生活质量。
Circumscribed choroidal hemangiomas are rare and benign tumors but often have a progressive course and are complicated by retinal detachment and glaucoma. The effectiveness of external radiation for large tumors that are difficult to treat with photodynamic therapy was recently reported; however, few studies have conducted long-term follow-ups. We encountered a
case of localized choroidal hemangioma that was treated with proton beam therapy and followed up for 15 years. A 37-year-old man was diagnosed with a 10 × 4 mm circumscribed choroidal hemangioma involving the macular area with retinal detachment. Proton beam therapy was performed at 26.4 Gy relative biological effectiveness (RBE) in 8 fractions. The choroidal hemangioma gradually shrank over three years, and the retinal detachment also improved. A cataract developed on the affected side 11 years after irradiation, and eye coordination issues developed 15 years after irradiation. Glaucoma was not observed during the follow-up period; however, visual acuity did not recover, and the patient developed light perception. Although vision was not preserved, proton beam therapy effectively shrank the tumor and maintained quality of life.