The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
Am J Ophthalmol. 2013 Jul;156(1):36-42.e1. doi: 10.1016/j.ajo.2013.01.026. Epub 2013 Mar 28.
To describe the clinical characteristics of ciliary body tumors, surgical outcomes, and factors associated with poor visual outcome and metastasis.
Retrospective case series.
Medical records of 27 patients with ciliary body tumors who underwent partial lamellar sclerouvectomy in a single-center setting (Seoul, South Korea) were reviewed. Surgical outcomes were reviewed, and clinical characteristics were analyzed with respect to visual prognosis and globe retention rate.
Tumors were diagnosed histopathologically as benign in 8 (30%) cases and as melanoma in 19 (70%) cases. Patients had a median age of 48 years. The median follow-up was 3.5 years (range, 0.5 to 6 years). The tumors had a median diameter of 11 mm and a median thickness of 9 mm. The globe was retained in 20 (74%) eyes, with visual acuity of 20/400 or better in 13 (48%) eyes and 20/40 or better in 6 (22%) eyes. Choroidal involvement of tumor (P = .003), larger diameter of tumor (P < .001), and thicker tumor (P < .001) were associated with poor visual outcome. Local recurrence (P = .003) and presence of epithelioid cells (P = .040) were predictive factors for metastasis in melanoma patients. Kaplan-Meier estimates of metastasis-free survival at 3 and 5 years for melanoma patients were 82% and 55%, respectively.
Partial lamellar sclerouvectomy is a reasonable primary therapeutic option in ciliary body tumors, and good visual prognosis is expected in selected cases.
描述睫状体肿瘤的临床特征、手术结果以及与不良视力预后和转移相关的因素。
回顾性病例系列研究。
回顾性分析了 27 例在单中心（韩国首尔）接受部分板层巩膜切除术的睫状体肿瘤患者的病历。评估了手术结果，并就视力预后和眼球保留率分析了临床特征。
肿瘤经组织病理学诊断为良性 8 例（30%），恶性黑色素瘤 19 例（70%）。患者中位年龄为 48 岁。中位随访时间为 3.5 年（范围：0.5 至 6 年）。肿瘤的中位直径为 11mm，中位厚度为 9mm。20 只眼（74%）保留了眼球，其中 13 只眼（48%）视力达到 20/400 或更好，6 只眼（22%）视力达到 20/40 或更好。肿瘤的脉络膜受累（P=.003）、肿瘤直径较大（P <.001）和肿瘤较厚（P <.001）与不良视力预后相关。局部复发（P=.003）和上皮样细胞存在（P=.040）是黑色素瘤患者发生转移的预测因素。黑色素瘤患者的无转移生存 Kaplan-Meier 估计值在 3 年和 5 年时分别为 82%和 55%。
部分板层巩膜切除术是睫状体肿瘤的一种合理的初始治疗选择，在选择合适的病例中可以获得良好的视力预后。
