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视网膜血管性增生肿瘤:334 例原发性与继发性肿瘤的临床对比特征。

Retinal vasoproliferative tumors: comparative clinical features of primary vs secondary tumors in 334 cases.

机构信息

The OcularOncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA.

出版信息

JAMA Ophthalmol. 2013 Mar;131(3):328-34. doi: 10.1001/2013.jamaophthalmol.524.

Abstract

OBJECTIVE

To compare the clinical features of primary vs secondary retinal vasoproliferative tumors (VPTs).

METHODS

Retrospective case series of 334 tumors in 295 eyes of 275 patients.

RESULTS

Of 275 patients with VPT, 41% (n = 113) were male and 59% (n = 162) were female, with a mean age of 44 years at presentation. Primary VPT occurred in 80% (n = 219) and secondary VPT, in 20% (n = 56) of patients. Secondary VPT (n = 67) occurred in eyes with retinitis pigmentosa (n = 15, 22%), pars planitis (n = 14, 21%), Coats disease (n = 11, 16%), previous retinal detachment surgery (n = 8, 12%), idiopathic peripheral retinal vasculitis (n = 4, 6%), familial exudative vitreoretinopathy (n = 3, 4%), and others (n = 12, 18%). The mean interval between diagnosis of underlying ocular condition and secondary VPT was 160 months. Statistically significant differences (P < .05) in clinical features (primary vs secondary VPTs) included mean age at presentation (46 vs 38 years), visual symptoms (74% vs 87%), poor visual acuity worse than 20/200 (15% vs 28%), bilaterality (4% vs 20%), multifocality (5% vs 15%), postequatorial tumor location (20% vs 33%), tumor basal dimension (6 vs 7 mm), anterior chamber cells (16% vs 30%), and vitreous cells (19% vs 48%).

CONCLUSIONS

Retinal vasoproliferative tumor can be primary (80%) or secondary (20%). Compared with primary VPT, secondary VPT is more often bilateral, multiple, and larger and occurs at an earlier age associated with poorer visual acuity.

摘要

目的

比较原发性与继发性视网膜血管性肿瘤(VPT)的临床特征。

方法

对 275 例患者的 295 只眼中的 334 个肿瘤进行回顾性病例系列研究。

结果

275 例 VPT 患者中,男性占 41%(n=113),女性占 59%(n=162),发病时的平均年龄为 44 岁。原发性 VPT 占 80%(n=219),继发性 VPT 占 20%(n=56)。继发性 VPT(n=67)发生于视网膜色素变性(n=15,22%)、中间葡萄膜炎(n=14,21%)、Coats 病(n=11,16%)、既往视网膜脱离手术(n=8,12%)、特发性周边视网膜血管炎(n=4,6%)、家族渗出性玻璃体视网膜病变(n=3,4%)和其他(n=12,18%)患者的眼中。继发于基础眼病与继发性 VPT 之间的平均间隔时间为 160 个月。在临床特征(原发性与继发性 VPT)方面存在统计学显著差异(P<0.05),包括发病时的平均年龄(46 岁 vs 38 岁)、视觉症状(74% vs 87%)、视力低于 20/200(15% vs 28%)、双眼性(4% vs 20%)、多发性(5% vs 15%)、后极部肿瘤位置(20% vs 33%)、肿瘤基底直径(6 毫米 vs 7 毫米)、前房细胞(16% vs 30%)和玻璃体细胞(19% vs 48%)。

结论

视网膜血管性肿瘤可为原发性(80%)或继发性(20%)。与原发性 VPT 相比,继发性 VPT 更常为双侧、多发性和更大,并发生于更年轻的患者,视力更差。

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