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原发性中枢神经系统淋巴瘤患者的眼部受累。

Ocular involvement in patients with primary CNS lymphoma.

机构信息

Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, 388-1 Pungnap-2-dong, Songpa-gu, Seoul 138-736, Korea.

出版信息

J Neurooncol. 2011 Mar;102(1):139-45. doi: 10.1007/s11060-010-0303-9. Epub 2010 Jul 24.

Abstract

To describe the demographics, clinical characteristics, and treatment outcomes in patients with primary CNS lymphoma (PCNSL) with ocular involvement. A retrospective chart review was conducted on 61 patients who were diagnosed with PCNSL from January 2000 to October 2008 at the Asan Medical Center, Seoul, Korea. Among 46 patients who underwent ophthalmologic examination, 13 (28%) showed intraocular involvement. Mean age at diagnosis was 52.8 years, and 54% of patients were female. Diagnosis of PCNSL was made by vitrectomy (1 patient) or brain biopsy and/or CSF cytology (12 patients). In 4 (31%) patients, ocular symptoms preceded CNS symptoms. The most common ocular symptom was decreased visual acuity. Nine patients showed bilateral involvement. Intraocular findings included retinal infiltrative lesions (3 eyes), vitritis/vitreous opacity (5 eyes), or both (14 eyes). In addition to systemic chemotherapy and/or radiotherapy, vitrectomy and/or intravitreal methotrexate was utilized in 8 patients. Mean survival duration was 32.2 months (range 2-120 months). Although rare, the number of patients with PCNSL seems to be increasing in Korea. Early detection and dedicated treatment of intraocular lymphoma may result in improved visual outcome.

摘要

描述原发性中枢神经系统淋巴瘤(PCNSL)伴眼内受累患者的人口统计学、临床特征和治疗结果。对 2000 年 1 月至 2008 年 10 月在韩国首尔的 Asan 医疗中心诊断为 PCNSL 的 61 例患者进行了回顾性图表审查。在接受眼科检查的 46 例患者中,有 13 例(28%)存在眼内受累。诊断时的平均年龄为 52.8 岁,54%的患者为女性。PCNSL 的诊断是通过玻璃体切除术(1 例)或脑活检和/或 CSF 细胞学检查(12 例)得出的。在 4 例(31%)患者中,眼部症状先于中枢神经系统症状出现。最常见的眼部症状是视力下降。9 例患者出现双侧受累。眼内表现包括视网膜浸润性病变(3 只眼)、眼炎/玻璃体混浊(5 只眼)或两者兼有(14 只眼)。除了全身化疗和/或放疗外,8 例患者还采用了玻璃体切除术和/或玻璃体内甲氨蝶呤治疗。平均生存时间为 32.2 个月(范围 2-120 个月)。尽管罕见,但韩国 PCNSL 的患者数量似乎在增加。早期发现和专门治疗眼内淋巴瘤可能会改善视力结果。

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