化学療法が奏効した転移性脈絡膜腫瘍における腫瘍周囲の血流変化

Blood flow changes around a metastatic choroidal tumor responsive to systemic chemotherapy

　62歳女性の乳癌からの転移性脈絡膜腫瘍において，腫瘍とその周囲の血流変化をレーザースペックル法で測定した。腫瘍は右眼黄斑部の上方にあり，大きさは6乳頭径で，矯正視力は1.0であった。腫瘍の耳側に血流が豊富な領域があつた。化学療法で腫瘍は縮小し平坦化した。化学療法終了後に腫瘍が再発したが，再び他の化学療法で平坦化した。視力は再発時に0.15に低下したが，0.6まで改善した。化学療法終了後，腫瘍とその耳側の血流は治療前よりも日月らかに減少し，当初あった耳側の血流豊富な領域は消失した。左眼の血流は全経過中ほぼ不変であった。レーザースペックル法は，転移性脈絡膜腫瘍周囲の血流変化と治療効果の判定に有用であった。

We measured the blood flow in and around a choroidal tumor metastatic from breast carcinoma in a 62-year-old female. A laser speckle method was used in the measurement. The tumor was 6 disc diameters across and was located superior to the macula in her right eye. The corrected visual acuity was 1.0. There was an area of richly perfused area temporal to the tumor. Systemic chemotherapy induced reduction and flattening of the tumor. It relapsed after cessation of chemotherapy but flattened again after another chemotherapy. The visual acuity decreased to 0.15 during relapse but recovered finally to 0.6. After chemotherapy, the blood flow in and around the tumor was significantly decreased from the pretreatment level. The area of increased blood flow temporal to the tumor had disappeared. Blood flow in the fellow eye remained unchanged throughout. This case illustrates the usefulness of laser speckle method in evaluating changes in blood flow and the therapeutic effect in and around metastic choroidal tumor.