ObjectiveTo observe the OCT angiography (OCTA) imaging features of isolated choroidal hemangioma (CCH).MethodsA retrospective case study. From January 2017 to February 2019, 18 CCH patients (18 eyes) diagnosed in the Affiliated Eye Hospital of Nanjing Medical University were included in the study. There were 13 males (13 eyes) and 5 females (5 eyes), with the mean age of 44.5 years. All the tumors were orange-red, with clear boundaries, located at the posterior pole or around the optic disc. OCTA was used to scan the 6 mm×6 mm of macular area or in the range of 6 mm×6 mm. After automatic image processing, the system provided the blood flow map of shallow capillary plexus, deep capillary plexus, outer retina and choroidal capillary plexus, as well as the corresponding structure en-face image and B-scan image.ResultsOCTA examination found that when the stratification line was adjusted to the periphery of the choroidal capillary layer, the blood flow map showed clear boundary of the tumor, and the blood vessels on the surface of the tumor presented a network crisscross with different thickness. B-scan image showed that the whole layer of retinal choroid at the tumor presented a dome-shaped uplift, and the neurocortical layer could be accompanied by thickening, subretinal effusion, exudation and splitting. En-face image showed that the boundary of the tumor was clear, the surrounding exudation was strong reflection in spots or patches, local pigmentation showed weak reflection, and the signal reflection was uneven.ConclusionOCTA can clearly show the vascular morphology on the surface of CCH.
Objective To explore the changes in the serum Cu2+and the indexes for the liver pathology and biochemistry before and after the copper needle retained in the central veins of the rabbit ears. Methods Fortynine New Zealandrabbits were randomly divided into 5 groups: Group A (copper needles retained for 1 d), Group B (3 d), Group C (5 d), Group D (7 d), and Group E (the control group, without any copper needles retained). In each experimental group, there were 10 rabbits, and in the control group there were 9 rabbits. The rabbits in each group were arranged to have their venous blood drawn for determination of theCu2+concentration, and for observation on the changes in the liver biochemicalindexes for 5 times before and after the copper needles were retained in the central veins of the rabbit ears. At the same time, a piece of the liver tissue ineach rabbit was taken for examination of the pathological changes. All the liver samples were given the basic pathological examination; if the liver sample hadsome extraordinary pathological features, the specific pathological examinationwould be given, even using the transmission electron microscope. Results After the copper needles were retained in the central veins of the rabbit ears, the Cu2+concentration increased with the passing time. The concentrations in the groups were 1.40±0.49 μg/ml in Group A, 1.45±0.53 μg/ml in Group B, 2.01±0.40 μg/ml in Group C, 2.38±0.83 μg/ml in Group D, and 1.34±0.45 μg/mlin Group E, respectively. There was a statistically significant difference between Group D and Group E(P＜0.05). There were no significant changes in the ALT and AST levels when compared with those before the copper needles were retained(P＞0.05); however, there was a considerably positive correlation on 1st day (r=0.686, P＜0.05), 5th day (r=0.712, P＜0.05), and 7th day (r=0.768, P＜0.01) when compared with those after the copper needles were retained. The histological examination showed that aseptic inflammation subsided with the time in part of the liver. The Masson staining and the Ag staining showed that there were no obvious changes in the hepatic lobules, with no fibrosis of the liver tissues found under light microscope. Conclusion There are no obvious toxic and side effects on the rabbit liver after the copper needles are retained in its central veins.
ObjectiveTo observe the clinical effect of prolonged photodynamic therapy (PDT) irradiation time combined with intravitreal injection of ranibizumab in the treatment of circumscribed choroidal hemangioma (CCH).MethodsA retrospective clinical study. From March 2012 to March 2018, 51 eyes of 51 patients diagnosed in Shenzhen Eye Hospital were included in the study. Among the patients, the tumor of 36 eyes were located in macular area, of 15 eyes were located outside macular area (near center or around optic disc). All patients underwent BCVA, color fundus photography, FFA, ocular B-scan ultrasonography and OCT examinations. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. OCT showed 48 eyes with macular serous retinal detachment. of 36 eyes with tumor located in macular area, the logMAR BCVA was 0.05±0.05, the tumor thickness was 4.5±2.2 mm, the diameter of tumor was 9.7±3.6 mm. Of 15 eyes with tumor located outside macular area, the logMAR BCVA was 0.32±0.15, the tumor thickness was 3.8±1.4 mm, the diameter of tumor was 7.7±1.9 mm. PDT was performed for all eyes with the irradiation time of 123 s. After 48 h, all patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml). At 1, 3 and 6 months after treatment, the same equipment and methods before treatment were used for related examination. BCVA, subretinal effusion (SRF), tumor leakage and size changes were observed. BCVA, tumor thickness and diameter before and after treatment were compared by t test.ResultsAt 6 months after treatment, the tumor was becoming smaller without scar formation. FFA showed that the blood vessels in the tumor were sparse compared with those before treatment, and the fluorescence leakage domain was reduced. OCT showed 43 eyes of macular serous detachment were treated after the combined treatment. The logMAR BCVA were 0.16±0.15 and 0.55±0.21 of the eyes with tumor located in or outside macular area, respectively. The difference of logMAR BCVA between before and after treatment was significant (t=－2.511, －2.676; P=0.036, 0.040). Both the tumor thickness (t=3.416, 3.055; P=0.011, 0.028) and diameter (t=4.385, 4.171; P=0.002, 0.009) of CCH patients were significantly reduced compared with that before treatment.ConclusionThe tumor of CCH can be reduced by prolonged PDT irradiation time combined with intravitreal injection of ranibizumab.
From 1986 through Dec. 1991, 305 cases of hemangioma were treated by local injection therapy with a follow-up of 3 to 48 months. The outcome was satisfactory, 278 cases were cured, and 27 cases were still under observation. The preparation of the tetracycline solution, the method of injection, the indications, the way of observation and nursing after injection were introduced, and the mechanism of action of its application, the diagnosis and treatment of the complications were discussed.
ObjectiveTo study the relationship between expression of Caspase-3 and regression of hemangioma. MethodsCaspase-3 expression was detected in 79 hemangiomas and 5 normal skin tissues by immunohistochemistry (SP). ResultsIn 79 hemangiomas, the positive rates of Caspase-3 expression in proliferating, involuting and involuted phases were 52.4%, 91.2% and 83.3%, respectively. The expression of Caspase-3 in involuted and involuting phases was higher than proliferating phase(Plt;0.05，Plt;0.01) and control group(Plt;0.01). There was no statistical difference between the latter two groups (Pgt;0.05). ConclusionCaspase3 is involved in the converting of hemangiomas from proliferating phase into involuting phase. The activation of Caspase-3 may induce apoptosis of endothelial cells, thus leading to the regression of hemagioma.
Abstract： Objective To investigate the clinicopathological characteristics, improve the accuracy of clinical diagnosis， and reduce postoperative complications of thoracic hemangioma. Methods Clinical records of 9 patients with thoracic hemangioma who underwent surgical resection in West China Hospital of Sichuan University from January 2006 to August 2012 were retrospectively analyzed. There were 2 males and 7 females with their average age of 47.9±19.3 （18-71）years. Six patients underwent thoracotomy， 1 patient underwent complete video-assisted thoracoscopic surgery （VATS）， 1 patient underwent video-assisted mini-thoracotomy， and 1 patient underwent staged operations which were performed by neurological surgeons and thoracic surgeons separately. Imaging characteristics, intraoperative gross tumor features, and pathological characteristics of resected hemangioma specimens were analyzed. Clinical outcomes of different surgical strategies for the treatment of hemangioma were compared. Results Nine patients with thoracic hemangioma were included in this study. Imaging studies showed the tumor as a round-shaped mass in 66.7% （6/9） of these patients and a lobulated mass in the remaining 33.3% （3/9） patients. Magnetic resonance imaging （MRI） assessment was helpful for preoperative diagnosis of hemangioma， with T2 weighted imaging tumor enhancement as the main MRI feature. Thoracic operation time was 106.3±60.1 （60-192） min， and intraoperative blood loss was 91.1±43.7 （30-150） ml. All the patients were followed up for 3-6 years except 1 patient who was followed up for 1 month. None of the patients had hemangioma-related death， recurrence or metastasis during follow-up. Conclusions Thoracic hemangiomas are usually benign entities and often locate in the mediastinum. Surgical strategies should be determined by the size and location of the tumor as well as the surgeon’s technique level. VATS has the advantages of being minimal invasive, causing less intraoperative blood loss and shorter length of hospital stay for the treatment of hemangioma. Resection of a dumbbell-type hemangioma may need cooperation between neurological and thoracic surgeons.
OBJECTIVE To discuss the methods selection on treatment of body surface hemangioma. METHODS From February 1983 to March 2001, 265 patients with different types of body surface hemangioma were treated with prednisone in 94 cases, laser in 102 cases, and plastic surgery operation in 69 cases respectively. RESULTS Followed up 6 months to 15 years, 70 cases with prednisone treatment were cured (74.5%), which meaned the hemangioma was totally removed and no recurrence in 6 months follow-up, 51 cases with laser treatment were cured (50%), while in the plastic surgery operation group, the cure rate was 98.6% (68 cases). CONCLUSION Treatment with prednisone, laser or plastic surgery operation are all effective to body surface hemangioma and proper treatment method should be selected according to different period and different type of hemangioma to improve the therapeutic effectiveness.
ObjectiveTo explore the therapeutic effect of transpupillary thermotherapy (TTT) on patient with circumscribed choroidal hemangioma (CCH).
MethodsThe clinical data of 16 patients (16 eyes) with circumscribed choroidal hemangioma (CCH) from December 2011 to December 2012, which had been diagnosed by clinical general examination, fundus fluorescein angiography (FFA), and B-scanning ultrasound examination were retrospectively analyzed. The follow-up period was 6-24 months (mean 14 months).
ResultsAmong the 8 eyes with peripheral retinal detachment in 16 cases of CCH, the peripheral subretinal fluid was completely absorbed in 6 eyes, and partially absorbed in 2 eyes after TTT. The resultant visual acuity after treatment improved in 12 eyes, and maintained no change in 4 eyes. The results of B-scanning ultrasound examination showed that the thickness of tumor went down in 12 eyes obviously. The results of FFA revealed a significant decrease of the leakage in tumor in all of 16 cases and no complication was observed.
ConclusionTTT is an effective therapy for CCH.
ObjectiveTo observe the effectiveness of radiotherapy for refractory choroidal hemangioma.
MethodsEight patients (8 eyes) with choroidal hemangioma were enrolled in this retrospective study. All the patients had received laser or photodynamic therapy before without effectiveness. The patients included 7 males and 1 females. The age was ranged from 11 to 54 years old, with an average of (27.50±15.18) years. All the patients were affected unilaterally, including 3 right eyes and 5 left eyes. There were 5 eyes with circumscribed choroidal hemangioma, 3 eyes with diffused choroidal hemangioma. All eyes had extensively exudative retinal detachment. The vision was from light sensation to 0.01. The volume of the tumors was ranged from 1.96 to 5.35 cm3, with a mean of (3.37±1.06) cm3. All the patients were treated with X rays by conventional fractional radiotherapy. Four of 8 patients were applied 24Gy totally in 8 fractions, while the other 4 patients were applied 46Gy in 23 fractions. Follow-up period ranged from 7 to 95 months, with medium of 42 months.
ResultsRetinas reattached in all the eyes while exudation being absorbed. No retinal detachment happened again. To the last follow-up, the vision was from light sensation to 0.6. Visual activity improved in 6 eyes while 2 eyes improved obviously. Visual acuity was stable in remaining 2 eyes. The volume of the tumors decreased to 1.24-2.16 cm3, with a mean of (1.68±0.30) cm3. The percentage of the tumor decreased by 14.6-72.7, with an average of (44.89±21.30)%. No radiotherapy-associated complication occurred.
ConclusionRadiotherapy is an efficient and safe treatment for refractory choroidal hemangioma.
Objective To evaluate the therapeutic effects of pingyangmycin in treatment of body surface hemangioma in children. Methods The clinical data of 1 658 children patients with hemangioma on body surface in which pingyangmycin was injected between January 1997 and January 2008 were analyzed retrospectively． Results All 1 658 patients were observed for 6-12 months, with average of 10.83 months． The total effective rate was 97.09%. Compared among different types of hemangioma, total effective rate had significant difference (χ2=203.12， P＜0.01), and complete remission (CR) rate had significant difference (χ2=287.97， P＜0.01). The therapeutic effect of pingyangmycin in treatment of cavernous hemangioma was better than that of strawberry hemangioma, mixed hemangioma and portwine stain, which was better instrawberry hemangioma than mixed hemangioma and portwine stain, and which was lower in portwine stain than other hemangiomas. Fifty-four patients (3.26%) caught partial necrotic ulcer of hemangioma. There were 418 cases (25.21%) of fever and 3 cases (0.18%) of allergic shock. Conclusion Intratumorally pingyangmycin injection is a simple， safe and effective therapy for hemangioma of body surface in children．
