Spaulding G
Trans Am Ophthalmol Soc. 1978;76:584-609.
The high incidence of rubeosis iridis accompanying retinoblastoma has been reaffired. Factor common to ocular tumors in general and retinoblastoma, as well as reactions to retioblastoma that have some contributory effect upon vascularization of the iris have been studied and complied. No single causative factor emerged, although tumor necrosis obviously played an important role. To a lesser extent, the site, location, and intraocular extension bore some relationship to neovascularization. That iris neovascularization carries a more grave prognosis, until now only a clinical impression, was definitely confirmed. Clinicians, therefore, studying patients with retinoblastoma would be well advised to pay more attention to the iris and anterior segment since recognition of changes leads to more timely and knowledgeable management. It was hoped that increased recognition of rubeosis would differentiate between eyes with retinoblastoma and those with pseudoglioma; however, an equally high incidence of neovascularization accompanied certain pseudogliomas. In both studies, as is often the case, numerous interesting observations were made; several with clinical implications. Finally, a frequently associated glaucoma, suggested by the anterior segment histologic features, went urecognized and unrecorded in these patients.
视网膜母细胞瘤伴发虹膜红变的高发病率已得到再次确认。对眼部肿瘤尤其是视网膜母细胞瘤共有的因素,以及对虹膜血管形成有一定促进作用的视网膜母细胞瘤反应进行了研究和整理。虽然肿瘤坏死显然起了重要作用,但未发现单一的致病因素。在较小程度上,肿瘤的部位、位置和眼内扩展与新生血管形成有一定关系。虹膜新生血管预示着更严重的预后,这一点此前只是临床印象,现已得到明确证实。因此,建议研究视网膜母细胞瘤患者的临床医生更多关注虹膜和眼前节,因为认识到这些变化有助于更及时、更明智地进行治疗。人们希望对虹膜红变的更多认识能区分视网膜母细胞瘤患者和假性胶质瘤患者;然而,某些假性胶质瘤也伴有同样高的新生血管发生率。在这两项研究中,常出现许多有趣的观察结果;其中一些具有临床意义。最后,根据眼前节组织学特征提示的一种常伴发的青光眼,在这些患者中未被识别和记录。