MacIntosh Peter W, Yoon Michael K, Fay Aaron
Department of Ophthalmology, Harvard Medical School , Boston, Massachusetts , USA and.
Semin Ophthalmol. 2014 Sep-Nov;29(5-6):450-5. doi: 10.3109/08820538.2014.959617.
Lymphatic malformations (LM) are associated with significant morbidity, and in the orbit, can lead to vision loss. Treatment of these lesions is complicated by their infiltrative nature, making surgical excision challenging. Bleomycin has been used since the 1970s for sclerosis of LM to reduce the need for or improve the success of surgical excision. This paper reviews the complications associated with intralesional bleomycin in the treatment of orbital LM.
A comprehensive literature search was performed on PubMed. Thirty full-length English articles were reviewed.
The pathophysiology and imaging characteristic of LM were first reviewed. The head and neck literature was heavily cited given the dearth of specific orbital data. This review highlights the common techniques and dosages for injection, the overall success rate of this treatment, and its common side effects. The orbital data were then reviewed, and differentiated from the head and neck literature.
Sclerotherapy of most LM with bleomycin appears to be safe and effective, but the lack of specific orbital data means we must extrapolate LM data from other fields to orbital LM with caution. Additional research is warranted, though the risk-benefit ratio remains unknown.
淋巴管畸形（LM）会引发严重的发病情况，在眼眶中可导致视力丧失。这些病变因其浸润性本质，使得治疗变得复杂，手术切除具有挑战性。自20世纪70年代以来，博来霉素一直用于LM的硬化治疗，以减少手术切除的需求或提高手术切除的成功率。本文综述了眼眶LM病灶内注射博来霉素相关的并发症。
在PubMed上进行了全面的文献检索。对30篇全文英文文章进行了综述。
首先综述了LM的病理生理学和影像学特征。鉴于缺乏特定的眼眶数据，大量引用了头颈部的文献。本综述重点介绍了注射的常用技术和剂量、该治疗的总体成功率及其常见副作用。然后对眼眶数据进行了综述，并与头颈部文献进行了区分。
用博来霉素对大多数LM进行硬化治疗似乎是安全有效的，但由于缺乏特定的眼眶数据，意味着我们必须谨慎地将其他领域的LM数据外推至眼眶LM。尽管风险效益比尚不清楚，但仍有必要进行更多研究。
