Shields C L, Shields J A, Shields M B, Augsburger J J
Oncology Service, Willis Eye Hospital, Philadelphia, PA 19107.
Ophthalmology. 1987 Jul;94(7):839-46. doi: 10.1016/s0161-6420(87)33537-7.
A survey of 2704 eyes with intraocular tumors in patients who were evaluated on the Oncology Service at Wills Eye Hospital showed that 126 of the tumor-containing eyes (5%) had tumor-induced elevated intraocular pressure (IOP) at the time of diagnosis of the tumor. Of the 2111 eyes with uveal melanomas, secondary IOP elevation was present in 55 (3%). Secondary IOP elevation was present in 7% of eyes with iris melanoma, 17% with ciliary body melanoma, and 2% with choroidal melanoma. The most common mechanism of elevated IOP was tumor invasion of the angle in the case of iris melanomas, pigment dispersion and tumor invasion of the angle in the case of ciliary body melanomas, and iris neovascularization in the case of choroidal melanomas. Of the 256 eyes with uveal metastases, secondary IOP elevation was found in 12 eyes (5%). Secondary IOP elevation was present in 64% of eyes with iris metastases, 67% with ciliary body metastases, and 1% with choroidal metastases. The most common mechanism of elevated IOP was tumor invasion of the angle in the case of iris and ciliary body metastases, and angle closure in the case of choroidal metastases. There were 303 eyes with retinoblastoma, 17% of which had elevated IOP which was secondary to iris neovascularization in 70% of cases and to an angle closure without neovascularization in 27%. Several other intraocular tumors including lymphoma, leukemia, medulloepithelioma, melanocytoma, and adenoma of the iris pigment epithelium were occasionally associated with secondary elevated IOP.
对在威尔斯眼科医院肿瘤科接受评估的2704例患有眼内肿瘤患者的2704只眼睛进行的一项调查显示，在诊断肿瘤时，126只含有肿瘤的眼睛（5%）存在肿瘤诱导的眼压（IOP）升高。在2111只患有葡萄膜黑色素瘤的眼睛中，55只（3%）出现继发性IOP升高。虹膜黑色素瘤患者的眼睛中有7%出现继发性IOP升高，睫状体黑色素瘤患者的眼睛中有17%出现继发性IOP升高，脉络膜黑色素瘤患者的眼睛中有2%出现继发性IOP升高。IOP升高的最常见机制是，虹膜黑色素瘤患者为肿瘤侵犯房角，睫状体黑色素瘤患者为色素播散和肿瘤侵犯房角，脉络膜黑色素瘤患者为虹膜新生血管形成。在256只患有葡萄膜转移瘤的眼睛中，12只（5%）发现继发性IOP升高。虹膜转移瘤患者的眼睛中有64%出现继发性IOP升高，睫状体转移瘤患者的眼睛中有67%出现继发性IOP升高，脉络膜转移瘤患者的眼睛中有1%出现继发性IOP升高。IOP升高的最常见机制是，虹膜和睫状体转移瘤患者为肿瘤侵犯房角，脉络膜转移瘤患者为房角关闭。有303只眼睛患有视网膜母细胞瘤，其中17%的眼睛眼压升高，70%的病例继发于虹膜新生血管形成，27%的病例继发于无新生血管形成的房角关闭。其他几种眼内肿瘤，包括淋巴瘤、白血病、髓上皮瘤、黑素细胞瘤和虹膜色素上皮腺瘤，偶尔也与继发性IOP升高有关。
