JAMA Ophthalmol. 2014 May;132(5):600-4. doi: 10.1001/jamaophthalmol.2013.8182.
Schnabel cavernous degeneration (SCD) has been observed in eyes with uveal melanoma (UM), but, to our knowledge, a definitive study establishing the association between SCD and UM has not been conducted.
To explore an association between SCD and UM.
DESIGN, SETTING, AND PARTICIPANTS: A historical cohort analysis was performed using histologic slides and related clinical records of cases from the Collaborative Ocular Melanoma Study and Eye Pathology Laboratory at the University of Wisconsin, including 1985 UM eyes, 517 eye bank eyes, and 155 enucleated glaucomatous eyes.
The prevalence of SCD was calculated and compared between each group; subgroup analysis was also conducted of eyes with and without SCD for the prevalence of glaucoma.
Schnabel cavernous degeneration was seen in 17 (0.9%) UM eyes, 9 (1.7%) eye bank eyes, and 2 (1.3%) enucleated glaucomatous eyes. No difference was detected between the prevalence of SCD in UM eyes and eye bank eyes (odds ratio [OR], 0.49; 95% CI, 0.22-1.10) or enucleated glaucomatous eyes (OR, 0.66; 95% CI, 0.15-2.89). Subgroup analysis, performed on 421 UM eyes, provided sufficient clinical information to definitively establish the presence or absence of glaucoma. Of the 95 (22.6%) eyes with glaucoma, 11 (11.6%) revealed histopathologic evidence of SCD. Compared with enucleated end-stage glaucoma eyes, this represents a 10-fold increase in SCD in UM eyes with glaucoma (OR, 10.10; 95% CI, 2.17-46.26). The prevalence of glaucoma in UM eyes with SCD, however, was respectively 7- and 15-fold higher than the prevalence of glaucoma in SCD-negative UM eyes (OR, 6.98; 95% CI, 2.51-19.43) and SCD-positive eye bank eyes (OR, 14.67; 95% CI, 1.46-146.97).
Although an association between SCD and UM was not confirmed, subgroup analysis did reveal an increased incidence of SCD in eyes with both UM and glaucoma. This suggests that the occurrence of glaucoma may increase the risk of SCD in eyes with UM.
在葡萄膜黑色素瘤（UM）眼中已经观察到 Schnabel 海绵状变性（SCD），但是，据我们所知，尚未进行过一项确定 SCD 与 UM 之间关联的研究。
探索 SCD 与 UM 之间的关联。
设计、地点和参与者：对威斯康星大学合作眼黑色素瘤研究和眼病理实验室的组织学切片和相关临床记录进行了历史队列分析，其中包括 1985 年 UM 眼、517 眼库眼和 155 例青光眼眼球摘除眼。
计算了 SCD 在每组中的患病率，并进行了比较；还对有和没有 SCD 的眼睛进行了亚组分析，以确定青光眼的患病率。
在 17 只（0.9%）UM 眼中、9 只（1.7%）眼库眼中和 2 只（1.3%）青光眼眼球摘除眼中观察到 Schnabel 海绵状变性。UM 眼和眼库眼之间（比值比 [OR]，0.49；95%置信区间，0.22-1.10）或青光眼眼球摘除眼（OR，0.66；95%置信区间，0.15-2.89）中 SCD 的患病率无差异。对 421 只 UM 眼进行的亚组分析提供了明确确定青光眼存在或不存在的足够临床信息。在 95 只（22.6%）患有青光眼的眼中，有 11 只（11.6%）显示出 SCD 的组织病理学证据。与青光眼末期眼球摘除眼相比，这代表青光眼 UM 眼中 SCD 的发病率增加了 10 倍（OR，10.10；95%置信区间，2.17-46.26）。然而，SCD 阳性 UM 眼的青光眼患病率分别是 SCD 阴性 UM 眼（OR，6.98；95%置信区间，2.51-19.43）和 SCD 阳性眼库眼（OR，14.67；95%置信区间，1.46-146.97）的 7 倍和 15 倍。
尽管未证实 SCD 与 UM 之间存在关联，但亚组分析确实显示出 UM 眼和青光眼眼中 SCD 发生率增加。这表明青光眼的发生可能会增加 UM 眼中 SCD 的风险。
