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眼内淋巴瘤:26 例患者的临床病理特征、玻璃体表现及治疗结果的描述性数据。

Intraocular Lymphoma: Descriptive Data of 26 Patients Including Clinico-pathologic Features, Vitreous Findings, and Treatment Outcomes.

机构信息

a Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , Massachusetts , USA.

b Ocular Immunology and Uveitis Foundation , Waltham , Massachusetts , USA.

出版信息

Ocul Immunol Inflamm. 2018;26(3):347-352. doi: 10.1080/09273948.2016.1193206. Epub 2016 Jul 20.

Abstract

PURPOSE

To describe clinical manifestations, diagnostic approaches, therapy, and outcomes of biopsy-proven intraocular lymphoma.

METHODS

Review of tertiary referral center records between 2005 and 2015.

RESULTS

A total of 51 eyes of 26 patients were included; mean age of onset was 60.42 years. Common ocular complaints included floaters (42%) and blurred vision (35%); 62% of patients had ocular and central nervous system involvement; 11% had systemic lymphoma; and 27% had only ocular involvement. Vitreous analysis was positive for malignant cells in 77% of patients on initial biopsy, and in 100% of patients on repeat biopsy. In total, 20/26 patients received systemic and topical treatment before IOL diagnosis was made; 25 patients received intravitreal methotrexate and/or rituximab; one patient received intracameral rituximab. All patients achieved remission by their final visit.

CONCLUSIONS

Intraocular lymphoma often masquerades as intraocular inflammation, resulting in delayed or misdiagnosis with subsequent inappropriate management. Optimal therapy is a challenge for oncologists and ophthalmologists.

摘要

目的

描述经活检证实的眼内淋巴瘤的临床表现、诊断方法、治疗和结果。

方法

回顾 2005 年至 2015 年期间在三级转诊中心的记录。

结果

共纳入 26 例患者的 51 只眼;发病的平均年龄为 60.42 岁。常见的眼部主诉包括飞蚊症(42%)和视力模糊(35%);62%的患者有眼内和中枢神经系统受累;11%有全身淋巴瘤;27%仅有眼部受累。77%的患者在初次活检时玻璃体分析显示恶性细胞阳性,100%的患者在重复活检时阳性。总共,在眼内液细胞学检查诊断之前,26 例患者中的 20 例接受了全身和局部治疗;25 例患者接受了玻璃体内甲氨蝶呤和/或利妥昔单抗治疗;1 例患者接受了眼内腔注射利妥昔单抗治疗。所有患者在最后一次就诊时均达到缓解。

结论

眼内淋巴瘤常表现为眼内炎症,导致诊断延迟或误诊,随后进行不适当的治疗。最佳治疗是肿瘤学家和眼科医生面临的挑战。

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