视网膜血管增生性肿瘤(RVPT)是一种不明原因、较为罕见的良性胶质细胞增生性肿瘤。眼底典型表现为颞下方周边视网膜黄色或粉红色肿瘤样病灶,常伴有视网膜下液、渗出、视网膜前膜等并发症。典型RVPT在荧光素眼底血管造影上表现为高荧光,静脉期和晚期表现为弥散性渗漏。眼部B型超声显示病灶呈不均匀中反射或高反射信号。不典型RVPT需与von Hippel-Lindau综合征所致的视网膜毛细血管瘤、Coats病、家族性渗出性玻璃体视网膜病变等相鉴别。RVPT的发病机制不明,组织病理学显示可能为胶质细胞的反应性增生。RVPT目前尚无统一治疗方案,主要针对瘤体进行冷冻、激光光凝、局部放射治疗、经瞳孔温热疗法或光动力疗法等,并发玻璃体积血视网膜及牵拉性视网膜脱离者可行玻璃体视网膜手术。本文就RVPT的临床特征、诊断与鉴别诊断、病理与发病机制以及治疗进展进行综述。
Retinal vasoproliferative tumor (RVPT) is a rare benign glial proliferative tumor of unknown origin.The fundus is typically characterized by yellow or pink tumor-like lesions of the retina around the inferior temporal region, often accompanied by subretinal fluid, exudation, epiretinal membrane and other complications.Typical RVPT showed high fluorescence on fundus fluorescein angiography, diffuse leakage in venous phase and late stage, uneven middle or high reflection signal on B-ultrasound, and it was not difficult to diagnose combined with fundus changes.Atypical RVPT should be differentiated from retinal capillary hemangioma caused by von Hippel-Lindau disease, Coats disease and familial exudative vitreoretinopathy.The pathogenesis of RVPT is unclear, but histopathology shows that it may be the reactive proliferation of glial cells.At present, there is no unified treatment plan for RVPT, mainly cryotherapy, laser photocoagulation, local radiotherapy, transpupillary thermal therapy or photodynamic therapy for tumor.For patients with vitreous hemorrhage, vitreoretinal surgery is feasible.This article reviewed the clinical features, diagnosis and differential diagnosis, pathology and pathogenesis, and treatment progress of RVPT.
孙功鹏,陈长征. 视网膜血管增生性肿瘤的诊疗进展[J]. 中华实验眼科杂志,2023,41(07):693-696.
DOI:10.3760/cma.j.cn115989-20200712-00488版权归中华医学会所有。
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