继发性青光眼作为葡萄膜黑色素瘤的初始表现
Secondary glaucoma as initial manifestation of uveal melanoma.
作者信息
Othman Ihab Saad, Assem Maher, Zaki Iman M A
机构信息
Ophthalmology Departments, Cairo University, Cairo, Egypt ; EyeWorld Hospital, Giza, Egypt.
出版信息
Saudi J Ophthalmol. 2013 Jul;27(3):203-8. doi: 10.1016/j.sjopt.2013.07.004.
PURPOSE
Secondary glaucoma can be induced by a variety of local ocular problems. Intraocular tumors may initially present as secondary glaucoma.
METHODS
8 consecutive patients with secondary glaucoma were found to have uveal melanoma. Thorough examination included detailed history, fundus examination with scleral depression, B scan ultrasonography, and CT/MRI scanning techniques.
RESULTS
A single case presented with spontaneous hyphema, two patients presented with secondary glaucoma, extraocular melanoma and metastases, a single case was found to have angle block by an iridociliary ring melanoma and 4 cases presented with neovascular glaucoma. Enucleation was necessary in all 8 cases.
CONCLUSIONS
General ophthalmologists should be aware of these rare initial manifestations of intraocular tumors as secondary glaucoma. Enucleation would be recommended in most cases of intraocular malignancy manifesting as secondary glaucoma. One should be extremely cautious in doing a penetrating surgery in such cases.
目的
多种局部眼部问题可诱发继发性青光眼。眼内肿瘤最初可能表现为继发性青光眼。
方法
连续8例继发性青光眼患者被发现患有葡萄膜黑色素瘤。全面检查包括详细病史、巩膜压迫眼底检查、B超超声检查以及CT/MRI扫描技术。
结果
1例出现自发性前房积血，2例出现继发性青光眼、眼外黑色素瘤及转移，1例发现虹膜睫状体环黑色素瘤导致房角阻滞，4例出现新生血管性青光眼。8例均需行眼球摘除术。
结论
普通眼科医生应了解眼内肿瘤作为继发性青光眼的这些罕见初始表现。对于大多数表现为继发性青光眼的眼内恶性肿瘤病例，建议行眼球摘除术。在此类病例中进行穿透性手术时应极其谨慎。
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