首页> 外文期刊>Retina >RETINAL BREAK AND RHEGMATOGENOUS RETINAL DETACHMENT AFTER TRANSPUPILLARY THERMOTHERAPY AS PRIMARY OR ADJUNCT TREATMENT OF CHOROIDAL MELANOMA.
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RETINAL BREAK AND RHEGMATOGENOUS RETINAL DETACHMENT AFTER TRANSPUPILLARY THERMOTHERAPY AS PRIMARY OR ADJUNCT TREATMENT OF CHOROIDAL MELANOMA.

机译:初次或辅助治疗脉络膜黑素病的经皮热疗后的视网膜裂孔和湿润性视网膜脱离。

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OBJECTIVE:: To report the development of retinal break or rhegmatogenous retinal detachment (RRD) after transpupillary thermotherapy (TTT) as primary or adjunct treatment of choroidal melanoma. METHODS:: In this noncomparative, interventional case series, the authors reviewed medical records of 13 patients who developed retinal break or RRD following TTT. The main outcome measures were clinical features and outcome of treatment of retinal break or RRD following TTT. RESULTS:: Of 1574 patients managed on the Oncology Service at Wills Eye Institute with TTT as primary or adjunct treatment of choroidal melanoma, 13 (1%) developed retinal break with or without RRD. The mean patient age at diagnosis of choroidal melanoma was 56 years. Treatment for choroidal melanoma included combined plaque radiotherapy and TTT in 10 patients and TTT alone in 3 patients. The median number of TTT sessions before development of retinal break or RRD was 2. Retinal break or RRD developed at a median of 3 months following the last TTT. All the retinal breaks were located in the TTT-treated area. Retinal breaks were atrophic in 11 eyes and horseshoe shaped in 2 cases. The extent of retinal detachment was none in 1 eye, 1 quadrant or less in 5 eyes, 2 or 3 quadrants in 4 eyes, and 4 quadrants in 3 eyes. Seven patients underwent vitrectomy, one received cryotherapy and laser photocoagulation, and five were observed without treatment. In all eight patients who received treatment for RRD, the retina was attached after a mean follow-up period of 54 months with no intraocular or local extraocular tumor dissemination. CONCLUSIONS:: Development of retinal break or RRD is a rare complication of TTT for treatment of choroidal melanoma. The majority of these cases develop within 6 months of TTT and most are caused by atrophic retinal holes in the TTT-treated area.
机译:目的:报告经瞳孔热疗(TTT)作为脉络膜黑色素瘤的主要或辅助治疗后视网膜断裂或类风湿性视网膜脱离(RRD)的发展。方法:在这个非比较性的介入病例系列中,作者回顾了13例在TTT后发生视网膜断裂或RRD的患者的病历。主要结局指标为TTT后的临床特征和视网膜裂孔或RRD的治疗结局。结果:在Wills眼科研究所的肿瘤科接受TTT作为脉络膜黑色素瘤的主要或辅助治疗的1574例患者中,有13例(1%)发生了视网膜裂变,伴或不伴RRD。诊断为脉络膜黑色素瘤的平均患者年龄为56岁。脉络膜黑色素瘤的治疗包括10例患者进行斑块放射治疗和TTT联合治疗,3例患者单独进行TTT治疗。在最后一次TTT后3个月的中位,视网膜裂隙或RRD发生前的TTT疗程中位数为2次。所有的视网膜折断都位于TTT治疗的区域。视网膜裂孔萎缩11眼,马蹄形2例。视网膜脱离的程度在1眼中没有,在5眼中没有1个象限,在4眼中是2或3象限,在3眼中是4象限。有7例患者接受了玻璃体切割术,其中1例接受了冷冻疗法和激光光凝术,其中5例未经治疗。在接受RRD治疗的所有八名患者中,在平均随访54个月后没有发生眼内或局部眼外肿瘤扩散的情况下,视网膜被附着。结论:视网膜裂孔或RRD的发展是TTT治疗脉络膜黑色素瘤的罕见并发症。这些病例大多数在TTT的6个月内发展,多数是由TTT治疗区域的视网膜萎缩引起的。

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