Alsarhani Waleed K, Al-Sharif Eman M, Al-Faky Yasser H, Alkatan Hind M, Maktabi Azza M, Alsuhaibani Adel H
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.; Department of Ophthalmology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Department of Ophthalmology, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
Can J Ophthalmol. 2022 Dec;57(6):388-393. doi: 10.1016/j.jcjo.2021.06.014. Epub 2021 Jul 26.
The study aims to describe the clinical and histopathologic features of different types of dacryops and their clinical diagnostic challenges.
This is a retrospective cohort study of all surgically excised cases of dacryops in 2 tertiary eye hospitals in Riyadh, Saudi Arabia.
The study included 58 dacryops specimens from 55 patients with an average age of 41.2 years (range, 4-78 years). The most common location was the upper lid (60.3%), whereas the least expected location was the caruncle (6.9%). The most common site of dacryops occurrence was in the accessory lacrimal gland (55.2%), the main lacrimal gland (32.8%), and then ectopic dacryops (12%). All patients presented with lid swelling alone except for 3 patients who experienced secondary mechanical ptosis. On physical examination, conjunctival scarring existed in 4 patients (6.9%). Preoperative diagnosis of dacryops was accurate in 44.8% of the cases. Dacryops of the main lacrimal gland was accurately diagnosed clinically in all cases compared with other locations, which was statistically significant (p < 0.001). The causes of inaccurate clinical diagnoses were hidrocystoma (26.9%), inclusion cyst (11.5%), and dermoid cyst (7.7%), whereas the remaining cases were diagnosed as cysts without a specific subtype (53.9%). Recurrence of the lesion was observed in 2 cases (3.5%). No clinical or histopathologic factors were associated with a risk of recurrence.
Dacryops can represent a diagnostic challenge to ophthalmologists. Familiarity with clinical presentations and findings is required to diagnose dacryops outside the main lacrimal gland.
本研究旨在描述不同类型泪腺脱垂的临床和组织病理学特征及其临床诊断挑战。
这是一项对沙特阿拉伯利雅得两家三级眼科医院所有手术切除的泪腺脱垂病例的回顾性队列研究。
该研究纳入了来自55例患者的58个泪腺脱垂标本，患者平均年龄为41.2岁（范围4 - 78岁）。最常见的部位是上睑（60.3%），而最意想不到的部位是泪阜（6.9%）。泪腺脱垂最常见的发生部位是副泪腺（55.2%）、主泪腺（32.8%），然后是异位泪腺脱垂（12%）。除3例出现继发性机械性上睑下垂的患者外，所有患者均仅表现为眼睑肿胀。体格检查时，4例患者（6.9%）存在结膜瘢痕。44.8%的病例泪腺脱垂术前诊断准确。与其他部位相比，主泪腺的泪腺脱垂在所有病例中临床诊断均准确，具有统计学意义（p < 0.001）。临床诊断不准确的原因包括潴留性囊肿（26.9%）、包涵囊肿（11.5%）和皮样囊肿（7.7%），而其余病例被诊断为无特定亚型的囊肿（53.9%）。2例患者（3.5%）观察到病变复发。未发现临床或组织病理学因素与复发风险相关。
泪腺脱垂可能给眼科医生带来诊断挑战。诊断主泪腺以外的泪腺脱垂需要熟悉其临床表现和检查结果。
