Schalenbourg Ann, Mantel Irmela
Rev Med Suisse. 2015 Dec 16;11(499):2395-8.
Cancer involves so rarely the eye that it may be recognized late. The most frequent primary intra-ocular tumours are retinoblastoma in small children and uveal melanoma in adults. Vision loss in systemic cancer has a varied differential diagnosis. Uveal metastases are most often associated with breast cancer, but can herald lung carcinoma. Masquerade syndrome looks like inflammation but represents the ocular involvement of primary CNS non-Hodgkin lymphoma. Systemic cancer drugs, as well as radiotherapy, can cause ocular toxicity, mostly at the retina. In the rare paraneoplastic syndromes, patient's cancer antibodies cross-react with retinal antigens, leading to severe vision loss. When cancer involves the eye, a fast referral into specialized care can significantly improve visual and vital prognosis.
癌症很少累及眼睛,因此可能发现较晚。最常见的原发性眼内肿瘤是小儿视网膜母细胞瘤和成人葡萄膜黑色素瘤。全身性癌症导致的视力丧失有多种鉴别诊断。葡萄膜转移瘤最常与乳腺癌相关,但也可能是肺癌的先兆。伪装综合征看似炎症,但实际上是原发性中枢神经系统非霍奇金淋巴瘤的眼部表现。全身性癌症药物以及放疗均可导致眼部毒性,主要累及视网膜。在罕见的副肿瘤综合征中,患者的癌症抗体与视网膜抗原发生交叉反应,导致严重视力丧失。当癌症累及眼睛时,迅速转诊至专科治疗可显著改善视力和生存预后。