Gailloud C, Zografos L, Uffer S, Egger E
Clinique ophtalmologique universitaire de Lausanne, Hôpital Jules Gonin.
Klin Monbl Augenheilkd. 1991 May;198(5):365-70. doi: 10.1055/s-2008-1045982.
In choroidal melanoma vitreous hemorrhage can occur as initial event or as complication of conservative therapy. To understand better these relations, four groups of cases were examined: 1.) 126 choroidal melanomas which were treated conservatively with Cobalt 60 applicator from 1969 till 1984. 2.) 715 choroidal melanomas which have been treated with proton-beam from 1984 to 1989. 3.) 7 tumors or pseudotumors for which for diagnostic purposes a phosphorus 32 test was necessary. 4.) 9 choroid melanomas which had conservative treatment and where vitrectomy was realized. The multifactorial analysis gave the following results: in vitreous hemorrhages occurring before treatment the thickness of the tumor represents the significant factor. In vitreous hemorrhages which occur after conservative treatment there is in the group of cobalt applicators important irradiation of the disc, as well as the thickness of the tumor and the age of the patient in the group with proton-beam irradiation. Vitreous bleeding occurring before or after therapy does not influence the vital prognosis in a negative way. We present here a therapeutic concept in cases of vitreous bleeding in choroid melanoma which is based both on our experience and on the indications of literature.
在脉络膜黑色素瘤中，玻璃体出血可作为首发事件出现，也可作为保守治疗的并发症出现。为了更好地理解这些关系，对四组病例进行了检查：1.）1969年至1984年期间用钴60敷贴器进行保守治疗的126例脉络膜黑色素瘤。2.）1984年至1989年期间用质子束治疗的715例脉络膜黑色素瘤。3.）7例肿瘤或假肿瘤，为诊断目的需要进行磷32试验。4.）9例接受保守治疗并进行了玻璃体切除术的脉络膜黑色素瘤。多因素分析得出以下结果：在治疗前发生的玻璃体出血中，肿瘤厚度是重要因素。在保守治疗后发生的玻璃体出血中，在钴敷贴器组中视盘受到重要照射，在质子束照射组中肿瘤厚度和患者年龄也有影响。治疗前后发生的玻璃体出血对生命预后没有负面影响。我们在此提出一种针对脉络膜黑色素瘤玻璃体出血病例的治疗理念，该理念基于我们的经验和文献指征。
