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成人T细胞白血病/淋巴瘤相关眼部表现:全国首次大规模调查分析

Adult T-Cell Leukemia/Lymphoma-Related Ocular Manifestations: Analysis of the First Large-Scale Nationwide Survey.

作者信息

Kamoi Koju, Okayama Akihiko, Izumo Shuji, Hamaguchi Isao, Uchimaru Kaoru, Tojo Arinobu, Ohno-Matsui Kyoko

机构信息

Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.

出版信息

Front Microbiol. 2019 Jan 8;9:3240. doi: 10.3389/fmicb.2018.03240. eCollection 2018.

Abstract

Adult T-cell leukemia/lymphoma (ATL) is a rare and aggressive T-cell malignancy with a high mortality rate, resulting in a lack of information among ophthalmologists. Here, we investigated the state of ophthalmic medical care for ATL and ATL-related ocular manifestations by conducting the first large-scale nationwide survey in Japan. A total of 115 facilities were surveyed, including all university hospitals in Japan that were members of the Japanese Ophthalmological Society and regional core facilities that were members of the Japanese Ocular Inflammation Society. The collected nationwide data on the state of medical care for ATL-related ocular manifestations and ATL-associated ocular findings were categorized, tallied, and analyzed. Of the 115 facilities, 69 (60%) responded. Overall, 28 facilities (43.0%) had experience in providing ophthalmic care to ATL patients. ATL-related ocular manifestations were most commonly diagnosed "based on blood tests and characteristic ophthalmic findings." By analyzing the 48 reported cases of ATL-related ocular manifestations, common ATL-related ocular lesions were intraocular infiltration (22 cases, 45.8%) and opportunistic infections (19 cases, 39.6%). All cases of opportunistic infection were cytomegalovirus retinitis. Dry eye (3 cases, 6.3%), scleritis (2 cases, 4.2%), uveitis (1 case, 2.1%), and anemic retinopathy (1 case, 2.1%) were also seen. In conclusion, intraocular infiltration and cytomegalovirus retinitis are common among ATL patients, and ophthalmologists should keep these findings in mind in their practice.

摘要

成人T细胞白血病/淋巴瘤(ATL)是一种罕见且侵袭性强的T细胞恶性肿瘤,死亡率高,导致眼科医生对此了解不足。在此,我们通过在日本开展首次大规模全国性调查,研究了ATL的眼科医疗状况以及与ATL相关的眼部表现。共调查了115家机构,包括日本眼科学会的所有日本大学医院以及日本眼部炎症学会的地区核心机构。对收集到的全国范围内关于ATL相关眼部表现的医疗状况数据以及ATL相关眼部检查结果进行了分类、统计和分析。115家机构中,69家(60%)做出了回应。总体而言,28家机构(43.0%)有过为ATL患者提供眼科护理的经验。ATL相关眼部表现最常通过“血液检查和典型眼科检查结果”进行诊断。通过分析48例报告的ATL相关眼部表现病例,常见的ATL相关眼部病变为眼内浸润(22例,45.8%)和机会性感染(19例,39.6%)。所有机会性感染病例均为巨细胞病毒性视网膜炎。还发现了干眼症(3例,6.3%)、巩膜炎(2例,4.2%)、葡萄膜炎(1例,2.1%)和贫血性视网膜病变(1例,2.1%)。总之,眼内浸润和巨细胞病毒性视网膜炎在ATL患者中很常见,眼科医生在实践中应牢记这些表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba72/6331419/d255ba387b17/fmicb-09-03240-g001.jpg

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