Department of Ophthalmology, Pitié Salpétrière Hospital, Paris, France.
Ocul Immunol Inflamm. 2012 Aug;20(4):273-6. doi: 10.3109/09273948.2012.689072. Epub 2012 May 30.
To determine the incidence and to discuss pathogenic mechanisms of sympathetic ophthalmia in patients treated for choroïdal melanoma.
Retrospective.
We analyzed the clinical and pathological data of 4867 patients, treated for choroïdal melanoma at Institute Curie-Orsay, between 1998 and 2011. Were involved patients with uveitis of the adelphe eye filling clinical and angiographic criteria of sympathetic ophthalmia. Extensive work-up was undertaken to rule out another etiology of the inflammation.
Three patients developed sympathetic ophthalmia respectively 7, 4 and 3 years after protontherapy.The incidence of this complication was 6.1 per 10000 patients treated by proton beam radiation. Ocular perforating injury was ruled out and radioactive effect of treatment was incriminated in the occurrence of sympathetic ophthalmia.
Sympathetic ophthalmia remains a rare complication which must be treated promptly and aggressively to prevent blindness.Proton beam irradiation could induce disruption of uveal tissue which enhances auto immune reactions.
确定接受脉络膜黑色素瘤治疗的患者发生交感性眼炎的发生率，并探讨其发病机制。
回顾性研究。
我们分析了 1998 年至 2011 年间在 Curie-Orsay 研究所接受脉络膜黑色素瘤治疗的 4867 例患者的临床和病理资料。纳入符合交感性眼炎的临床和血管造影标准的对侧眼葡萄膜炎患者。我们进行了广泛的检查以排除炎症的其他病因。
3 名患者分别在质子治疗后 7、4 和 3 年发生交感性眼炎。这种并发症的发生率为每 10000 例接受质子束放射治疗的患者中 6.1 例。排除了眼球穿孔伤，并认为放射性治疗作用与交感性眼炎的发生有关。
交感性眼炎仍然是一种罕见的并发症，必须迅速积极治疗，以防止失明。质子束照射可能会破坏葡萄膜组织，从而增强自身免疫反应。
