Woo Young Jun, Kim Chang Yeom, Sgrignoli Bradford, Yoon Jin Sook
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Saint John's Episcopal Hospital, Far Rockaway, NY, USA.
Korean J Ophthalmol. 2017 Jun;31(3):194-201. doi: 10.3341/kjo.2016.0034. Epub 2017 May 12.
To report the patient characteristics and treatment outcomes in 12 cases of orbital lymphangioma.
In this study, orbital lymphangioma was diagnosed based on clinical, radiologic (computed tomography, magnetic resonance imaging), and histologic findings when possible. Patients whose vision was not compromised by orbital lymphangioma, or that did not have increased intraocular pressure (IOP), received oral corticosteroids. Orbital lymphangioma that affected vision or increased IOP was treated by surgery, which included aspiration of blood or partial resection with or without injection of a sclerosant.
Four patients without compromised vision responded well to oral corticosteroids. Eight patients with compromised vision underwent some form of surgery. Bleeding recurred in three patients after aspiration of blood and in two after partial resection and intralesional injection of a sclerosant. Overall, five patients were treated successfully by aspiration of blood, intralesional injection of a sclerosant, and application of continuous negative pressure by appropriate drainage. Partial resection was successful in two patients with organized hematoma.
Orbital lymphangioma that does not compromise vision can be treated medically using oral corticosteroids. Patients with threatened vision or elevated IOP due to acute hemorrhage should be treated by aspiration of blood, intralesional injection of a sclerosant, and application of continuous negative pressure. Partial resection may be effective only in patients with organized hematoma.
报告12例眼眶淋巴管瘤的患者特征及治疗结果。
在本研究中，眼眶淋巴管瘤尽可能根据临床、影像学（计算机断层扫描、磁共振成像）及组织学检查结果进行诊断。视力未受眼眶淋巴管瘤影响或眼压未升高的患者接受口服皮质类固醇治疗。影响视力或导致眼压升高的眼眶淋巴管瘤采用手术治疗，包括抽吸血液或部分切除，可联合或不联合注射硬化剂。
4例视力未受影响的患者对口服皮质类固醇治疗反应良好。8例视力受影响的患者接受了某种形式的手术。3例患者在抽吸血液后出血复发，2例在部分切除及瘤内注射硬化剂后出血复发。总体而言，5例患者通过抽吸血液、瘤内注射硬化剂及适当引流施加持续负压治疗成功。2例有机化血肿患者部分切除成功。
不影响视力的眼眶淋巴管瘤可用口服皮质类固醇进行药物治疗。因急性出血导致视力受威胁或眼压升高的患者应通过抽吸血液、瘤内注射硬化剂及施加持续负压进行治疗。部分切除可能仅对有机化血肿的患者有效。
