Zhang Ting, Feng Lu-Jia, Wang You, Shi Yun-Hong, Wang Li, Sun Yi-Meng, Wei Yan-Tao, Zhang Shao-Chong
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China.
Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China.
Int J Ophthalmol. 2022 Mar 18;15(3):446-452. doi: 10.18240/ijo.2022.03.12. eCollection 2022.
To delineate the different imaging characteristics of uveal schwannoma from melanoma and discuss the optimal treatment strategy for intraocular schwannoma.
Case series of three patients diagnosed with intraocular schwannoma was collected at Zhongshan Ophthalmic Center, Guangzhou, China from July 2014 to December 2020. All the study patients underwent ultrasonography and magnetic resonance imaging (MRI). The clinical features, therapeutic strategies, and prognoses of all patients were reviewed.
Ultrasonography of all three patients (all females, mean age, 39y, age range, 23-54y) showed low to medium reflectivity with a homogeneous internal structure. MRI of all three patients demonstrated isointensity on T1-weighted imaging spin-echo (T1WI SE) images and hypointense on fast spin-echo T2-weighted images (FSE T2WI) images with respect to the brain. Minimally invasive pars plana vitrectomy (PPV) and local resection of the tumor was performed for all patients, and the diagnosis of schwannoma was confirmed by histopathological examination.
The present study indicates that ultrasonography and MRI features of uveal schwannoma may contribute to the differentiation of uveal schwannoma from melanoma, and the optimal therapy for intraocular schwannoma is minimally invasive PPV and local resection.
明确葡萄膜神经鞘瘤与黑色素瘤不同的影像学特征,并探讨眼内神经鞘瘤的最佳治疗策略。
收集2014年7月至2020年12月在中国广州中山眼科中心确诊为眼内神经鞘瘤的3例患者的病例系列。所有研究患者均接受了超声检查和磁共振成像(MRI)。回顾了所有患者的临床特征、治疗策略和预后情况。
3例患者(均为女性,平均年龄39岁,年龄范围23 - 54岁)的超声检查均显示为低至中等回声,内部结构均匀。3例患者的MRI在T1加权成像自旋回波(T1WI SE)图像上呈等信号,在快速自旋回波T2加权图像(FSE T2WI)上相对于脑呈低信号。所有患者均接受了微创玻璃体切割术(PPV)及肿瘤局部切除术,组织病理学检查确诊为神经鞘瘤。
本研究表明,葡萄膜神经鞘瘤的超声和MRI特征有助于其与黑色素瘤的鉴别,眼内神经鞘瘤的最佳治疗方法是微创PPV及局部切除术。