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首页> 外文期刊>Ocular oncology and pathology. >Choroidal Ischemia Sparing the Watershed Zone following Intra-Arterial Chemotherapy for Retinoblastoma
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Choroidal Ischemia Sparing the Watershed Zone following Intra-Arterial Chemotherapy for Retinoblastoma

机译：脉络膜缺血在视网膜母细胞瘤中动脉内化疗后备受流域区

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Purpose: Intra-arterial chemotherapy (IAC) has become a mainstay in the management of retinoblastoma, especially in advanced or refractory disease. However, IAC is not without complications, and chemotherapy toxic effects can lead to partial or complete choroidal ischemia, often causing vision loss. Methods: This is a case report. Results: A 4-month-old girl with bilateral retinoblastoma was treated with secondary IAC (melphalan 5 mg) for recurrent tumor following intravenous chemotherapy. One month later, complete tumor control was achieved. However, she demonstrated broad choroidal ischemia in the nasal and temporal quadrants but sparing of the watershed zone superior and inferior to the optic disc and in the papillomacular region. Fluorescein angiography revealed poor perfusion of the choriocapillaris with visibility of the large choroidal vessels in the nasal and temporal areas but preserved perfusion of the watershed zone. The watershed zone remained intact on the 10-month follow-up, and the final visual acuity was fix and follow without strabismus. Conclusion: The pathophysiology of choroidal ischemia is not well understood, but the fortuitous watershed zone preservation in this case could represent uneven distribution of the chemotherapeutic drug, resulting in partial chemo-dilution of the medication in the watershed region, which represents the final downstream overlapping choroidal perfusion from both medial and lateral posterior ciliary arteries.
机译：目的：动脉内化疗（IAC）已成为视网膜母细胞瘤的管理，特别是在先进或难治性疾病中。然而，IAC并非没有并发症，化疗毒性效应会导致部分或完全的脉络膜缺血，通常会导致视力丧失。方法：这是一个案例报告。结果：静脉化疗后，用二边形视网膜母细胞瘤进行双侧视网膜母细胞瘤的一个4个月大的女孩进行治疗。一个月后，实现了完整的肿瘤控制。然而，她在鼻腔和时间象限中展示了宽的脉络膜缺血，而是将流域区域优于和较差的光盘和乳头状区域。荧光素血管造影揭示了芝麻皮菌的灌注不良，具有鼻腔和颞段区域的大型脉络膜容器的可见性，但保留了流域区域的灌注。流域区对10个月的随访保持完整，最终的视力是修复的，没有斜视的情况下。结论：脉络膜缺血的病理生理学尚未得到很好的理解，但在这种情况下，偶然的流域保护区可以代表化学治疗药物的不均匀分布，导致流域区域中的药物部分化学稀释，这代表了最终下游重叠脉络膜灌注来自内侧和外侧后睫状体动脉。

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