Wei Cheng-hua, Qian Jiang, Yao Yi-qun, Yuan Yi-fei, Wu Hai-xiang
Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai 200031, China.
Zhonghua Yan Ke Za Zhi. 2010 Jan;46(1):29-33.
To study the diagnosis and treatment of 17 patients with sarcoidosis in ocular adnexa.
The clinical data of 17 cases with sarcoidosis in ocular adnexa treated during 1993 and 2008 were retrospectively analyzed. All patients underwent surgical treatment, and the diagnosis was proven histopathologically.
Among the 17 cases, 4 were male, and 13 were female. The patients' age ranged from 15 to 70 years, with a mean of 46.9 years. The lesions were located at the orbit (8 cases), lacrimal grand (5 cases) and eyelids (4 cases). Fourteen cases complained of the presence of a local mass, 2 cases complained of exophthalmos and 1 swelling of eyelids. Concurrent systemic sarcoidosis was present in 7 cases. Three cases coincided with lung sarcoidosis, 3 cases with uveitis and 1 case with dermatopathy. Angiotensin converting enzyme analysis was performed in 6 cases; 4 of them were elevated. Computer tomography was performed in 12 cases; in 11 cases it presented as moderate density parenchymatous mass, and in the remaining one it presented as hypodensity cystic mass. B scan of 5 cases showed hypoechoic parenchymatous homogeneous mass. None of 14 cases relapsed after 1 to 15 years follow-up.
Ocular adnexal sarcoidosis usually presents as local mass and it should be included in the differential diagnosis of orbital and ocular adnexal lesions. Excision of localized mass alone could achieve satisfactory outcomes for isolated lesions, while for diffuse or systematic lesions, corticosteroid treatment should be prescribed routinely.
研究17例眼附属器结节病的诊断与治疗。
回顾性分析1993年至2008年期间治疗的17例眼附属器结节病患者的临床资料。所有患者均接受手术治疗,诊断经组织病理学证实。
17例中,男性4例,女性13例。患者年龄15至70岁,平均46.9岁。病变位于眼眶8例、泪腺5例、眼睑4例。14例主诉有局部肿块,2例主诉眼球突出,1例眼睑肿胀。7例合并全身结节病。3例合并肺部结节病,3例合并葡萄膜炎,1例合并皮肤病。6例行血管紧张素转换酶分析,4例升高。12例行计算机断层扫描,11例表现为中等密度实质性肿块,1例表现为低密度囊性肿块。5例行B超检查,均显示低回声实质性均匀肿块。14例随访1至15年无复发。
眼附属器结节病通常表现为局部肿块,应列入眼眶及眼附属器病变的鉴别诊断。对于孤立性病变,单纯切除局部肿块即可取得满意疗效,而对于弥漫性或系统性病变,则应常规给予糖皮质激素治疗。