Romanowska-Dixon Bozena
Katedry i Kliniki Okulistyki Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Klin Oczna. 2003;105(3-4):136-9.
Analysis of the clinical picture of intraocular metastatic tumors and the results of the treatment with various methods.
Between 1994-1997 intraocular metastatic tumors were diagnosed in 14 patients (19 eyes). There were 13 females and 1 male, aged 28 to 69 years (average 50). The primary tumor in 8 patients developed in the breast, in 4 cases in the lungs, 1 in the brain, and 1 in the kidney. In all patients the primary tumor was excised, then chemotherapy was applied in 9 cases, radiotherapy in 3 cases, and hormonal treatment in 2 cases. In 7 patients the metastatic process concerned also other organs: bones, liver, lungs, hypophysis, and lymphatic glands. Metastases developed in 10 months to 11 years since the diagnosis and treatment of the primary tumor. Intraocular tumors were the most often located near the optic disc (8 cases), or near the macula (4 cases). There were usually flat tumors (in 12 cases < 5 mm in thickness), creamy white, sometimes with pigment clamping. In order, to confirm the diagnosis of the tumor, USG was always performed and in 8 cases fluorescein angiography. In all cases topical treatment was applied, which consisted of irradiation with ruthenium (106Ru) in 6 eyes (in 1 case two times), laser coagulation in 3 eyes, and thermotherapy (TTT) with diode laser in 4 eyes, combined treatment (106Ru + TTT) in 2 eyes, 106Ru and 125I brachytherapy in one eye. The dose of radiation for the apex of the tumor was 60-90 Gy (av. 65). The eyeball was enucleated in 3 patients, 4 patients received chemotherapy. 2 patients received hormonal therapy, applied together with the topical treatment.
In the majority of cases (14 eyes), a flat scar or the significant decrease of the volume of the tumor was obtained. 8 patients died, two are currently observed, the remaining 4 do not come to the control examination, and there is no information as to their fate.
Good results of the treatment encourage further application of brachy and thermotherapy in the treatment of intraocular metastatic tumors. It allows for the conservative treatment of the eyeball, and also useful visual acuity is retained often.
分析眼内转移性肿瘤的临床表现及各种治疗方法的效果。
1994年至1997年间，14例患者（19只眼）被诊断为眼内转移性肿瘤。其中女性13例，男性1例，年龄28至69岁（平均50岁）。8例患者的原发肿瘤发生在乳腺，4例在肺部，1例在脑部，1例在肾脏。所有患者均切除了原发肿瘤，随后9例患者接受了化疗，3例接受了放疗，2例接受了激素治疗。7例患者的转移过程还累及其他器官：骨骼、肝脏、肺部、垂体和淋巴结。转移发生在原发肿瘤诊断和治疗后的10个月至11年。眼内肿瘤最常位于视盘附近（8例）或黄斑附近（4例）。肿瘤通常扁平（12例厚度<5mm），呈乳白色，有时伴有色素沉着。为了确诊肿瘤，均进行了超声检查，8例进行了荧光素血管造影。所有病例均采用局部治疗，其中6只眼采用钌（106Ru）照射（1例照射两次），3只眼采用激光凝固，4只眼采用二极管激光热疗（TTT），2只眼采用联合治疗（106Ru + TTT），1只眼采用106Ru和125I近距离放疗。肿瘤顶端的放射剂量为60 - 90Gy（平均65Gy）。3例患者眼球摘除，4例患者接受化疗。2例患者接受激素治疗，并与局部治疗联合应用。
大多数病例（14只眼）获得了扁平瘢痕或肿瘤体积显著减小。8例患者死亡，2例目前正在观察中，其余4例未前来复查，也没有关于他们情况的信息。
治疗的良好效果鼓励在眼内转移性肿瘤的治疗中进一步应用近距离放疗和热疗。这使得能够对眼球进行保守治疗，并且常常能保留有用的视力。
