helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2019-12-2-39-47helmholtzeyeinstitute-272Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESДифференциальная диагностика капиллярных гемангиом сетчатки и вазопролиферативных опухолейDifferential diagnosis of retinal capillary hemangiomas and vasoproliferative tumorsНероевВ. В.NeroevV. V.

член-корр. РАН, д-р мед. наук, профессор, директор

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Corresponding member of RAS, Dr. Med. Sci., Professor, director

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

КиселеваТ. Н.KiselevaT. N.

д-р мед. наук, профессор, начальник отдела ультразвуковых исследований

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Dr. Med. Sci., Professor, head of ultrasound diagnostic department

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062 

НовиковаА. Ю.NovikovaA. Yu.

аспирант отдела патологии сетчатки и зрительныого нерва

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Ph. D. student, department of retinal and optic nerve pathology

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062 

РябинаМ. В.RyabinaM. V.

канд. мед. наук, старший научный сотрудник отдела патологии сетчатки и зрительныого нерва

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Cand. Med. Sci., Senior researcher, department of retinal and optic nerve pathology

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062 

ИлюхинП. А.IlyukhinP. A.

канд. мед. наук, научный сотрудник отдела патологии сетчатки и зрительныого нерва

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Cand. Med. Sci., Researcher, department of retinal and optic nerve pathology

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062 

paulilukhin@gmail.comРамазановаК. А.RamazanovaK. A.

канд. мед. наук, научный сотрудник  отдела ультразвуковых исследований

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Cand. Med. Sci., Researcher, ultrasound diagnostic department

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062 

ФГБУ «Московский НИИ глазных болезней им. Гельмгольца» Минздрава РоссииРоссияMoscow Helmholtz Research Institute of Eye DiseasesRussian Federation2019110620191223947Copyright © Нероев В.В., Киселева Т.Н., Новикова А.Ю., Рябина М.В., Илюхин П.А., Рамазанова К.А., 20192019Нероев В.В., Киселева Т.Н., Новикова А.Ю., Рябина М.В., Илюхин П.А., Рамазанова К.А.Neroev V.V., Kiseleva T.N., Novikova A.Y., Ryabina M.V., Ilyukhin P.A., Ramazanova K.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/272

Цель работы — представить основные дифференциально-диагностические критерии капиллярной гемангиомы сетчатки (КГС) и вазопролиферативной опухоли (ВПО) для повышения эффективности диагностики этих заболеваний.

Материал и методы

Материал и методы. Проведено комплексное офтальмологическое обследование 19 (26 глаз) пациентов в возрасте 19–66 лет (в среднем 31,89 ± 11,30 года) с сосудистыми новообразованиями сетчатки периферической локализации, включавшее, помимо стандартных методов, фундус-фоторегистрацию, флюоресцентную ангиографию (ФАГ), оптическую когерентную томографию сетчатки и комплексное ультразвуковое исследование с использованием режимов В-сканирования, эходенситометрии, цветового допплеровского картирования (ЦДК) и импульсной допплерографии (ИД).

Результаты

Результаты. На основании анализа особенностей клинической картины и результатов выполненных исследований выявлены следующие дифференциально-диагностические критерии: возраст развития КГС и ВПО, их локализация на глазном дне, значение акустической плотности образования, вовлеченность парного глаза, величина максимальной систолической скорости кровотока в центральной вене сетчатки.

Заключение

Заключение. Дифференциальная диагностика КГС и ВПО требует комплексного подхода и должна основываться не только на данных анамнеза и клинической картине, но и на результатах инструментальных методов исследования: ФАГ, эхографии и ЦДК.

Purpose

Purpose. To propose the major differential diagnostic criteria of retinal capillary hemangioma (RCH) and vasoproliferative tumor (VPT) aimed at increasing the efficiency of the diagnosis of these diseases.

Material and methods

Material and methods. A comprehensive ophthalmologic examination off 19 (26 eyes) patients, aged 19 to 66 (ave. 31.89 ± 11.30 yrs), with vascular neoplasms of peripheral localization included, beside the standard techniques, fundus photoregistration, fluorescent angiography (FAG), optical coherence tomography of the retina and a combined ultrasound testing using B scanning, echographic densitometry, colour Doppler imaging (CDI), and pulse Doppler imaging.

Results

Results. Based on the analysis of the clinical picture and the results of the tests performed, the following differential diagnostic criteria were proposed: the age at which RCH and VPT developed, their localization in the eye fundus, and the value of the maximal systolic blood flow velocity in the central vein of the retina.

Conclusion

Conclusion. Differential diagnostics of RCH and VPT requires combined approaches and should take into account, in addition to case history and the clinical picture, also the results of instrumental testing techniques: FAG, echography and CDI.

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The authors declare that there are no conflicts of interest present.