retinal capillary hemangioma
Introduction
Introduction to retinal capillary hemangioma Retinal hemangioma is often a part of systemic hemangiomatosis, often accompanied by cerebellum, cerebral ventricle, spinal cord, adrenal gland, kidney, liver, epididymis and ovarian hemangioma, cyst or tumor, of which cerebellar hemangioblastoma is the most common, basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: retinal detachment glaucoma cataract
Cause
Causes of retinal capillary hemangioma
(1) Causes of the disease
The cause may be dysplasia of the ectoderm, or originated from the mesoderm, but some organs have a resting or hidden state, clinical asymptomatic and physical signs, so that it is difficult to find, its genetic penetrance is incomplete or the expression is mutated. The clinical findings are extremely inconsistent, often in the same family of patients with different manifestations, between the family members and the proband, the lesions can also be different, and some only intracranial or other organ lesions without retinal blood vessels There are also the opposites, so ophthalmologists must also recognize the symptoms and signs of intracranial lesions, often 10 years after retinal hemangioma, so von Hippel disease is likely to be an early manifestation of von Hippel-Lindau disease. ,
(two) pathogenesis
still not clear.
Prevention
Retinal capillary hemangioma prevention
1. Prohibition of alcohol.
2. Use skim milk or yogurt.
3. No more than 2 egg yolks a day.
4, avoid using animal oil, the total amount of vegetable oil does not exceed 20g.
5, do not eat animal offal, chicken skin, fat and fish, crab yellow.
6, avoid fried food.
7, do not eat chocolate.
8, often eat less oily soy products and gluten.
9. Eat 500g of fresh green vegetables every day.
10. The daily intake of salt is limited to 5-6g.
11, after eating fruit to reduce the amount of staple food, eat an apple a day, you should reduce the staple food 50 grams.
12, yam, sweet potato, taro potatoes, etc., should be exchanged with the main food rice, flour, the total amount should be limited.
Complication
Retinal capillary hemangioma complications Complications retinal detachment glaucoma cataract
Can be complicated by retinal detachment, glaucoma, complicated cataract and so on.
Symptom
Retinal capillary hemangioma symptoms Common symptoms Retinal edema Retinal hemorrhage Retinal vein variability Irritation retinal detachment
Clinically, von Hippel disease is generally divided into five phases:
1. In the initial peripheral part of the fundus, there are small hemangioma or capillary tangled into a mass, sometimes the tumor is small, and the ophthalmoscope is not easy to find. The fundus fluorescein angiography can be seen in the capillary network between the small artery and the small vein. .
2. Vasodilation and hemangioma formation The disease occurs mostly in the retina of the fundus, and the affected retinal arteries and veins are distorted, distorted, and follow the vascular path to the peripheral part. It can be seen that the capillaries at the junction of the arteries and veins are highly expanded into a spherical shape. Hemangioma, which gradually increases thereafter, can reach 2~3PD or more (Fig. 1). The tumor is red and round or oval. In the first and second stages, the hemangioma is mostly confined to the peripheral part, and the patient often has no feeling.
3. Localized retinal edema and exudation at and near the hemangiomas in the exudation and hemorrhage, may be accompanied by small bleeding spots. The surface of the tumor and the surrounding retina are gray-white turbid due to leakage of the vascular tumor wall, and the course of disease is long. The water in the exudate is absorbed, the lipid is deposited, and a ring-shaped or curved yellow-white large piece of hard exudation occurs around the hemangioma. When the exudation affects the macula, the visual acuity is obviously damaged.
4. Retinal detachment period As the hemangioma continues to increase, the exudation also gradually increases, and the retina exudes detachment.
5. Late stage may result in complete loss of vision due to secondary glaucoma, uveitis, traction retinal detachment, complicated cataract or atrophy of the eye.
Examine
Examination of retinal capillary hemangioma
1. Genetic examination and genetic examination,
2. Pathological examination due to congenital mesodermal deformity, abnormal vascular development, tumors are proliferated by hemangioblasts, there are reticulovascular endothelial cells between blood vessels, which form pseudo-yellow tumor cells due to phagocytic lipids. Local retinal glial cell proliferation is obvious,
Fundus fluorescein angiography (FFA): It is very important for the diagnosis of this disease. The arteries can see the rapid filling of the tumor in the arteries. At the same time, the veins connected to it also have obvious laminar flow. Fluorescein leaks into a strong fluorescent mass (Figure 2),
Diagnosis
Diagnosis and diagnosis of retinal capillary hemangioma
In the early stage of the disease, the high expansion of capillaries and microscopic spherical hemangioma occur in the retina of the periorbital side of the fundus. It can be used for early diagnosis. When there is suspicion, fundus fluorescein angiography, when entering the second stage, hemangiomas It is very obvious (Fig. 1), and there is a hypertonic distortion of the arteries and veins associated with it. The diagnosis is no longer difficult.
The disease should be differentiated from vascular hemangioma, which has large tortuous and vine-like entangled blood vessels, but no hemangioma and yellow-white lipid deposits, sometimes the disease may be confused with isolated choroidal hemangioma Most of the latter are located around the posterior disc of the fundus, with apricot or orange-red bulge, pigmentation on the surface or edge, and no abnormalities in the retinal blood vessels.
