Stephens R F, Shields J A
Oncology Unit, Retina Service, Wills Eye Hospital, Philadelphia, PA 19130.
Ophthalmology. 1979 Jul;86(7):1336-49. doi: 10.1016/s0161-6420(79)35393-3.
Although metastatic cancer to the uvea is reported to be the most common intraocular malignancy, most ophthalmologists have had little experience with its diagnosis and treatment. This report describes our experience with the diagnosis and management of 70 patients with metastatic cancer to the uvea. Many patients were evaluated with modern diagnostic modalities such as fluorescein angiography, ultrasonography, and the 32P test when indicated. Thirty-one percent of patients had no history of previous malignancy, and the ocular complaints represented the first symptoms of systemic cancer. The ocular malignancy often simulated better-known ophthalmic entities, and the referring diagnosis was correct in only 38% of cases. This series, therefore, reflects the clinical problem confronting the practicing ophthalmologist. About one-half of the patients were treated with external beam irradiation to the involved eye(s), which often resulted in dramatic resolution of the tumor and visual return. Other patients had either no treatment, chemotherapy, or enucleation in selected instances.
尽管据报道葡萄膜转移性癌是最常见的眼内恶性肿瘤，但大多数眼科医生对其诊断和治疗经验甚少。本报告描述了我们对70例葡萄膜转移性癌患者的诊断和管理经验。许多患者在必要时接受了荧光素血管造影、超声检查和32P试验等现代诊断方法的评估。31%的患者既往无恶性肿瘤病史，眼部症状是全身性癌症的首发症状。眼部恶性肿瘤常酷似更为人熟知的眼科疾病，转诊诊断仅38%正确。因此，本系列病例反映了执业眼科医生面临的临床问题。约一半的患者接受了患眼的外照射治疗，这常常使肿瘤显著消退并恢复视力。其他患者则在某些情况下未接受治疗、接受了化疗或眼球摘除术。
