Koch K R, Mor J M, Avgitidou G, Kakkassery V, Rokohl A C, Heindl L M
Zentrum für Augenheilkunde, Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland.
Ophthalmologe. 2019 Apr;116(4):313-323. doi: 10.1007/s00347-019-0861-y.
The differentiation of iridic space-occupying lesions represents a regularly reoccurring diagnostic challenge.
This article presents an overview of the epidemiological data and describes the diagnostic procedure for iris tumors.
The article provides a review of the literature from PubMed and own clinical results.
Melanocytic lesions comprise the vast majority of all iris tumors and include nevi and melanomas. Slit lamp biomicroscopy with standardized photography reveals two-dimensional planar tumor growth over time, which is the only recognized clinical surrogate finding for a malignant event. Ultrasound biomicroscopy (UBM) is additionally obligatory because it is the only method which enables documentation of the extent of tumor penetration, ciliary body involvement and internal structure of iris tumors.
Serial slit lamp and UBM examinations with reproducible pupillary diameters are indispensable for the differentiation of cystic, solid and tumor-simulating lesions and for the detection of malignant transformation in iris tumors.
虹膜占位性病变的鉴别是一个经常反复出现的诊断难题。
本文概述流行病学数据,并描述虹膜肿瘤的诊断程序。
本文回顾了来自PubMed的文献及自身临床结果。
黑素细胞性病变占所有虹膜肿瘤的绝大多数,包括痣和黑色素瘤。标准化摄影的裂隙灯生物显微镜检查可显示肿瘤随时间的二维平面生长情况,这是目前唯一公认的提示恶性事件发生的临床替代指标。此外,超声生物显微镜检查(UBM)是必需的,因为它是唯一能够记录肿瘤浸润范围、睫状体受累情况以及虹膜肿瘤内部结构的方法。
采用可重复的瞳孔直径进行系列裂隙灯和UBM检查,对于鉴别囊性、实性和肿瘤样病变以及检测虹膜肿瘤的恶变情况不可或缺。