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1.
化学减容治疗眼内期视网膜母细胞瘤   总被引:3,自引:1,他引:2  
目的观察眼内期视网膜母细胞瘤患儿接受化学减容治疗的疗效。方法对2000年1月至2004年12月间于中山眼科中心行化学减容治疗眼内期视网膜母细胞瘤的9例患儿10只眼进行观察分析。其中男性5例,女性4例;单侧1例,双侧8例。首次就诊时平均年龄为31个月(11-95个月),首次化疗时平均年龄为36.1个月(11-97个月)。结果5只眼(5例患者)化疗效果较好,化疗结束后基底直径平均减少了31.1%(-0.2%-59.3%),厚度平均减少了50.6%(28.6%-83.2%),其中1例在化疗结束18个月后肿瘤复发行眼球摘除,其余4例随访至今(平均20个月)无复发及转移。4只眼在治疗中肿瘤持续长大或出现新的病灶而行摘除眼球;1例因出现脑转移在化疗2个疗程后死亡。眼球保留率为40%。所有9例患者可耐受化疗引起的副作用,无严重并发症发生。结论化学减容对眼内期视网膜母细胞瘤有一定的疗效,是一种有潜力的保守治疗方法。  相似文献   

2.
60例睫状体占位性病变的临床病理统计分析   总被引:3,自引:0,他引:3  
目的 分析睫状体占位性病变的组织来源,临床特点和组织病理学特征,为临床提供诊断和治疗依据。方法 对我院近50年间收治的60例睫状体占位性病变患者的临床和病理资料进行回顾性分析。结果 按组织来源分类,色素细胞来源肿瘤38例(63.3%),其中黑色素瘤34例(56.7%),是睫状体最常见的占位性病变,黑色素细胞瘤4例(6.7%);睫状体神经上皮来源肿瘤13例(21.7%),其中无色素上皮腺瘤11例(18.3%),无色素上皮腺癌2例(3.3%);神经源性肿瘤3例(5%),髓上皮瘤,神经纤维瘤和神经鞘瘤各1例(1.7%);另有平滑肌瘤5例(8.3%)、肉芽肿性炎症1例(1.7%)。结论 睫状体肿瘤早期诊断困难,了解其临床特点和组织病理学特征,将有助于临床医生作出正确的诊断和治疗。  相似文献   

3.
目的:分析对治疗后的视网膜母细胞瘤进行眼内手术的结果,并且对眼部及全身结果进行评估。设计:回顾性非比较性病例研究。患者:在视网膜母细胞瘤治疗后进行眼内手术的连续45例患者。主要结果测评:(1)视网膜母细胞瘤的复发,(2)需行眼球摘除术,(3)全身转移。当不存在上述评测结果,总结果判定为满意,而当存在1项或更多结果,则判定为不满意。结果:34例患者(76%)仅接受了白内障手术,单纯巩膜扣带术,或经睫状体平坦部玻璃体切割术1种手术,而11例(24%)患者接受了2种或更多的联合手术。总计16例患者(36%)获得的最终视力好于20/200。不满意的结果包括有14例(31%)视网膜母细胞瘤复发,16例(36%)眼球摘除术,3例(7%)全身转移。5例(20%)接受白内障手术,5例(63%)接受巩膜扣带术和9例(75%)接受经睫状体平坦部玻璃体切割术。在视网膜母细胞瘤的治疗结束与眼内手术的时间间隔在结果满意的患者中为26个月,而在结果不满意的患者中为6个月。结论:在某些特定的临床情况下,对治疗后的视网膜母细胞瘤患者进行眼内手术有充分理由。在大多数病例中,白内障手术是安全和有效的。然而,巩膜扣带术和经睫状体平坦部玻璃体切割术可能伴有视网膜母细胞瘤复发、眼球摘除术和全身转移的高风险性,因此有理由采用谨慎的方法。  相似文献   

4.
3476例眼眶占位性病变的组织病理学分类   总被引:50,自引:1,他引:49  
He Y  Song G  Ding Y 《中华眼科杂志》2002,38(7):396-398
目的:了解眼眶病组织病理学分类及分布状态。方法:对1976-2000年3476例眼眶肿瘤手术切除标本进行病理学分类。结果:眼眶病病种有100余种。良性肿瘤2847例(81.90%),其中前10位依次为海绵状血管瘤515例(18.09%),静脉性血管瘤364例(12.79%),炎性假瘤347例(12.19%),皮样囊肿(表皮样囊肿)230例(8.08%),神经鞘瘤183例(6.43%),脑膜瘤150例(5.27%),泪腺混合瘤147例(5.16%),黏液囊肿141例(4.95%),静脉曲张132例(4.64%)及神经纤维瘤76例(2.67%)。恶性肿瘤629例(18.10%),其中泪腺上皮性恶性肿瘤129例(20.51%),横纹肌肉瘤75例(11.92%),非霍奇金淋巴瘤65例(10.33%),继发性副鼻窦癌51例(8.11%),转移癌50例(7.95%),绿色瘤32例(5.09%),视网膜母细胞瘤球外蔓延26例(4.13%),脉络膜黑色素瘤球外蔓延23例(3.66%。结论:眼眶病中最常见的疾病为脉管源肿瘤及血管畸形;眼眶原发恶性肿瘤主要为泪腺上皮性恶性肿瘤;纤维硬化型炎性假瘤病理形态不同于其他类型炎性假瘤,提示其发病机制的不同。  相似文献   

5.
视网膜母细胞瘤的B超声像图与病理诊断对照分析   总被引:2,自引:0,他引:2  
目的 探讨视网膜母细胞瘤的超声图像特征与病理诊断的关系,旨在提高RB超声定性诊断的准确性。方法 本文采用法国产BVI眼科专用A/B超声诊断仪,对98例视网膜母细胞瘤进行超声探查,全病例均经手术及病理证实,并逐一进行对照分析。结果 全病例超声图像与病理诊断完全相符,即声像图显示玻璃体腔内实质性肿块回声的93例(93/98,94.9%)病变部位瘤细胞丰富排列较紧密;86例(86/98,87.8%)可见散在的斑点状强回声,部分伴有声影,而组织病理学检查可见明显钙化;49例(49/98,50.0%)声像图显示在肿物回声的后方有一线样的强回声带,与肿物发生粘连,为继发性视网膜脱离;38例(38/98,38.8%)肿物回声团内出现形态不规则的弱回声或无回声区(暗区),为细胞稀少或有坏死、液化表现;27例(27/98,27.6%)可探及眼球后壁回声欠清,视神经回声带增宽,则提示肿瘤有向眶内或颅内转移的可能;5例(5/98,5.1%)肿瘤呈囊性型回声。则多提示晚期病灶。结论 B超在视网膜母细胞瘤的临床诊断及鉴别诊断中有极高的应用价值。  相似文献   

6.
145例中男112例(78.9%)女33例(21.1%),年龄最大74岁,最小1岁8月。5岁以下28例占19.3%,16~60岁115例占79.3%,70岁以上2例占2.4%。就诊时间:最早为伤后20分钟,最迟为23天,24小时内就诊为96例占66.2%。致伤物:刀、剪刀、铁丝、铁屑83冽57.2%,雷管爆炸,子弹击伤6例4.1%,鸡啄伤5例3.5%,木柴、树技伤8例5.5%,玻璃片伤23例15.9%,石块伤20例13.8%。伤口情况:角膜伤口≤3mm23例15.9%,伤口>3mm,65例44.8%,角膜巩膜联合伤31例21.3%,巩膜伤口26例17.9%。视力情况:人院视力0.3以上9例6.2%,…  相似文献   

7.
997例眼眶占位性病变的组织病理学分类   总被引:10,自引:1,他引:10  
孙宏霞  肖利华  朱惠 《眼科》2005,14(6):369-372
目的探讨眼眶占位性病变组织病理学分类及分布情况。设计回顾性病例系列研究。研究对象997例眼眶肿瘤手术患者。方法记录患者的性别、年龄、眼别、病理结果。主要指标肿瘤的病理组织学。结果良性肿瘤800例,其中前10位依次为海绵状血管瘤169例(21.13%),炎性假瘤98例(12.25%),静脉性血管瘤73例(9.13%),皮样囊肿(表皮样囊肿)65例(8.13%1,脑膜瘤63例(7.88%),泪腺多形性腺瘤55例(6.88%1,神经鞘瘤46例(5.75%1,脉管瘤34例(4.25%1,神经纤维瘤25例(3.13%),静脉曲张22例(2.75%)。恶性肿瘤197例,其中前5位依次为泪腺上皮性恶性肿瘤48例(24.37%),非霍奇金淋巴瘤47例(23.86%),继发性肿瘤29例(14.72%),横纹肌肉瘤18例(9.14%),绿色瘤12例(6.09%)。结论眼眶占位病变种类繁多,良性肿瘤中以海绵状血管瘤最为多见,恶性肿瘤中以泪腺上皮性肿瘤多见。  相似文献   

8.
背景:几乎得不到有关视盘转移瘤的资料。目的:确定视盘转移瘤患者的临床特点和预后。设计:回顾性图表复习。结果:连续评估的660例患眼内转移的患者中,30例(4.5%)(31只眼)有转移癌至视盘;24例(80%)为妇女,6例(20%)为男性。眼部诊断时的均值年龄为55岁。原发肿瘤在乳腺内有13例患者(43%),在肺内有8例(27%),在肠内有1例(3%);在肾内有1例(3%),在前列腺有1例(3%);6例(20%)从未明确原发肿瘤。视盘转移在29例患者(97%)为单侧,1例(3%)为双侧。眼底镜下,26只眼(84%)内视盘转移显示为视盘弥散性扩大,5只眼(16%)为显著的结节。23只眼(74%)内转移 性视盘病变有1个相邻近的乳头旁脉络膜成分,8只眼(26%)内视盘被累及而无视网膜或脉络膜成分。其他伴同的所见包括所有眼内有某种程度的继发性视盘水肿,23只眼(74%)内视盘血管被掩盖,13只眼(42%)有裂片状出血。在行细针吸活组织检查的所有5只眼内,这种方法对确定诊断是有用的。诊断视盘转移后均值存活13个月。结论:至视盘的转移占所有内眼转移的5%。可以发生于来自乳头旁脉络膜转移的侵犯或为孤立的视盘转移。乳腺癌和肺癌为转移至视盘最常见的原发肿瘤。在20%的患者中,原发部位从未以确定。视盘转移的特征性临床特点必能有助于将其与肿胀视盘的其他相鉴别。患者预后不良。  相似文献   

9.
苏帆  肖利华 《眼科》2014,(4):243-246
目的分析良性病变行眶内容剜除术的适应证。设计回顾性病例系列。研究对象1999年11月至2010年8月武警总医院眼眶病研究所行眶内容剜除术的良性病变患者37例。方法回顾性分析患者的病例资料。主要指标眶内容剜除术原因、术式,病理诊断。结果全眶内容剜除术35例(94.6%),后部眶内容剜除术2例(5.4%)。全眶内容剜除术联合放射性^131I粒子植入术1例(2.7%)。病理诊断为炎性假瘤11例(29.7%),多形性腺瘤8例(21.6%),脑膜瘤6例(16.2%),韦格纳肉芽肿性病变4例(10.8%),血管外皮细胞瘤2例(5.4%),副神经节瘤、血管瘤、神经纤维瘤、纤维脂肪血管瘤、婴儿色素性神经外胚层肿瘤、眼眶结核各1例(2.7%)。眶内容剜除术原因:肿瘤切除术后复发或多次复发占86.5%,术眼视力无光感占54.1%,不可控制的疼痛占43.2%,肿瘤大或范围广占40.5%,长期用糖皮质激素或放疗但病情仍进展占27.0%。结论对于眼眶良性病变因局部切除术后复发而困扰的患者,如伴有视力丧失,肿瘤大或范围广,不可控制的疼痛者,可行眶内容剜除术。该术式用于眼眶良性病变治疗时,可彻底清除病灶、最大限度降低复发率。  相似文献   

10.
目的 探讨临床行人工晶状体置换术的原因、手术方法和效果。方法 回顾性分析20例(21眼)人工晶状体置换术的原因和手术方法,并对手术效果进行观察。结果 行人工晶状体置换术的原因为人工晶状体位置异常10例10眼(47.6%),人工晶状体瞳孔夹持6例7眼(33.3%),屈光度数误差2例21眼(9.5%),人工晶状体襻脱落2例2眼(9.5%)。手术置换人工晶状体的方法包括晶状体囊袋内植入5眼(23.8%),睫状沟固定6眼(28.6%),植入前房型人工晶状体10眼(47.6%)。术后裸眼远视力≥0.5者12眼(57.1%),0.1~0.4者8眼(38.1%),〈0.1者1眼(4.8%)。术后并发症包括术后一过性高眼压1例,前房出血1例,晶状体后囊膜混浊1例。结论 人工晶状体位置异常、瞳孔夹持、屈光度数误差及人工晶状体襻异常是行人工晶状体置换术的主要原因;掌握操作技巧可减少白内障摘除人工晶状体植入术后人工晶状体异常情况发生;人工晶状体置换术是处理人工晶状体异常的有效方法。  相似文献   

11.
Clinical spectrum of primary ophthalmic rhabdomyosarcoma   总被引:6,自引:0,他引:6  
PURPOSE: To review the clinical presentation, histopathologic analysis, management, and ocular and systemic outcome of rhabdomyosarcoma affecting the ocular region. DESIGN: Retrospective, noncomparative, consecutive, interventional case series. PARTICIPANTS: Thirty-three consecutive patients with primary ophthalmic involvement of rhabdomyosarcoma from a single tertiary care center specializing in ocular oncology. MAIN OUTCOME MEASURES: Final visual acuity, treatment complications, local recurrence, and distant metastasis. RESULTS: The mean age at presentation was 10 years (median, 7 years; range, 1 month-68 years). At presentation, 8 patients (24%) were older than age 10 years and 4 patients (12%) were older than 20 years. The rhabdomyosarcoma was primarily located in the orbit in 25 cases (76%), conjunctiva in 4 cases (12%), eyelid in 1 case (3%), and uveal tract in 3 cases (9%). Symptoms or signs related to the tumor were present for a mean of 5 weeks and included proptosis in 10 patients (30%), eyelid swelling in 7 patients (21%), and blepharoptosis in 6 patients (18%). The initial diagnosis before referral to us included rhabdomyosarcoma in 8 cases (24%), conjunctivitis in 5 cases (15%), orbital or preseptal cellulitis in 5 cases (15%), idiopathic orbital inflammatory pseudotumor in 4 cases (12%), and others. Using the Intergroup Rhabdomyosarcoma Study Group staging and treatment protocols, the tumor was classified as group I in 4 cases (12%), group II in 12 cases (36%), group III in 16 cases (48%), and group IV in 1 case (3%). Treatment included surgical debulking and various regimens of chemotherapy and radiotherapy for the periocular tumors and enucleation for the three intraocular tumors. Local tumor recurrence was detected in 6 patients (18%). Orbital exenteration was necessary for tumor recurrence in 2 cases (6%). Long-term visual outcome of the 28 patients who maintained their globe was 20/20 to 20/40 in 11 patients (39%), 20/50 to 20/100 in 5 patients (18%), and 20/200 to no light perception in 12 patients (43%). Regional lymph node metastasis was detected in 2 patients (6%), one at initial visit and one after therapy. Distant metastasis occurred in 2 patients (6%), one detected at initial visit and one after therapy. With mean follow-up of 8.3 years, tumor-related death occurred in 1 patient (3%). CONCLUSIONS: Rhabdomyosarcoma can present in the orbit, eyelid, conjunctiva, and uveal tract. After treatment, local tumor recurrence occurs in 18%, metastasis in 6%, and death in 3%.  相似文献   

12.
OBJECTIVE: To determine the incidence of specific orbital tumors based on patients referred to an ocular oncology center. DESIGN: Retrospective, observational case series. PARTICIPANTS: A total of 1264 consecutive patients referred to an ocular oncology service because of space-occupying orbital lesions. METHODS: A retrospective chart review was carried out for 1264 consecutive patients referred for a suspected orbital mass over a 30-year period. The lesions were grouped into general categories, as shown in "Results." The specific diagnosis in each case was based on clinical findings, computed tomography scan results, magnetic resonance imaging results, and histopathologic analysis results, when available. The number and percentage of benign and malignant tumors per age group also was determined. MAIN OUTCOME MEASURES: The incidence of orbital tumors and pseudotumors. RESULTS: Among 1264 consecutive patients, the number and percentage of lesions in each general category were as follows: cystic, 70 cases (6%); vasculogenic, 213 cases (17%); peripheral nerve lesions, 23 (2%); optic nerve and meningeal tumors, 105 (8%); fibrocytic lesions, 13 (1%); osseous and fibro-osseous tumors, 21 (2%); cartilaginous lesions, 1 (<1%); lipocytic and myxoid lesions, 64 (5%); myogenic tumors, 36 (3%); lacrimal gland lesions, 114 (9%); primary melanocytic lesions, 11 (<1%); metastatic tumors, 91 (7%); lymphoma and leukemia lesions, 130 (10%); secondary orbital tumors, 142 (11%); histiocytic lesions, 17 (1%); thyroid-related orbitopathy, 67 cases (5%); other inflammatory lesions, 133 cases (11%); and miscellaneous other lesions, 13 (1%). The most common diagnoses were: lymphoid tumor (139 cases;11%), idiopathic orbital inflammation (135 cases; 11%), cavernous hemangioma (77 cases; 6%), lymphangioma (54 cases; 4%), meningioma (53 cases; 4%), optic nerve glioma (48 cases; 4%), metastatic breast cancer (44 cases;4%), orbital extension of uveal melanoma (41 cases; 3%), capillary hemangioma (36 cases;3%), rhabdomyosarcoma (35 cases; 3%), dermolipoma (31 cases; 3%), herniated orbital fat (30 cases; 2%), dermoid cyst (26 cases; 2%), varix (26 cases; 2%), dacryops (19 cases; 2%), and other less common lesions. Of the 1264 lesions, 810 (64%) were benign and 454 (36%) were malignant. The percentage of malignant lesions was 20% in children (age range, 0-18 years), 27% in young adults and middle-aged patients (age range, 19-59 years), and 58% in older patents (age range, 60-92 years). Rhabdomyosarcoma was the most common malignancy in children, representing 3% of all orbital masses, and lymphoma was the most common malignancy in older patients, representing 10% of cases. CONCLUSIONS: A variety of tumors and pseudotumors can involve the orbit. In this series of 1264 lesions, 64% were benign and 36% were malignant. The percentage of malignant tumors increased with age, with malignancies being common in older patients because of the higher incidence of lymphoma and metastasis in the elderly.  相似文献   

13.
目的 观察眼球严重雷管爆炸伤的特点以及2期玻璃体切割手术治疗的效果。方法 回顾分析37例雷管爆炸伤患者65只眼的临床资料。男性36例,女性1例;平均年龄28.6岁。双眼伤31例,占83.8%;单眼伤6例,占16.2%。48只眼为严重爆炸伤眼,视力无 感9只眼,其中3只眼明显萎缩;光感28只眼;眼前手动4只眼;数指/33cm 7只眼。46只眼行玻璃体切割手术治疗,其中41只眼为严重爆炸伤眼。未行手术治疗的19眼中13只眼无玻璃体手术指征;6只眼因眼球萎缩或经济原因放弃手术治疗。就诊时间在伤后1周以内者7例,占18.9%;1周~1个月者13例,占35.2%;1个月以上者17例,占45.9%。手术后随访6个月~2年,平均随访时间8.6个月。结果 65只眼中结膜异物占66.2%;角膜异物占46.2%;玻璃体积血占70.8%;球内异物占69.2%。视网膜震荡伤或视神经冲击伤占56.9%。视力提高33只眼;不变25只眼;下降7只眼。46只玻璃体切割手术眼中,眼球内异物伤35只眼,占76.1%。视力提高26只眼,占59.5%;未提高13只眼,占28.3%;未治愈7只眼,占15.2%,其中眼球摘除2只眼,眼球萎缩5只眼。就诊时间超过1个月的患者手术后视力提高率低。单眼盲51.4%;双眼盲8.1%。结论 严重眼雷管爆炸伤大部为多发球内异物伤,就诊晚,伤情严重致盲率高,加强视网膜震荡和视神经冲击伤的诊治,尽早玻璃体切割手术可提高预后视功能。  相似文献   

14.
目的评估25G经结膜无缝合玻璃体切除手术系统(TSV 25G)在闭合性眼外伤玻璃体积血手术治疗中的应用价值。方法回顾性分析应用TSV 25G治疗20例20眼闭合性跟外伤玻璃体积血的临床资料。结果20例中除1例外,余均顺利完成手术,手术时间30~44min,平均时间36min。1例术中穿刺口漏水,缝合1针。手术后住院时间3~7d,平均4.5d;12例视力恢复至0.8以上占60.00%,其余8例合并视神经视网膜脉络膜挫伤,视力也有不同程度的提高。结论TSV 25G应用于闭合性眼外伤玻璃体积血手术治疗,操作安全且手术时间短,效果较好。  相似文献   

15.
Regional ocular blood flow after chronic topical glaucoma drug treatment   总被引:2,自引:0,他引:2  
The effects of a chronic three times a day treatment over a 5 to 6 week period of rabbit eyes with 1 of 5 topically applied glaucoma drugs on ocular blood flow was determined using a radioactive microsphere technique. The drugs employed were timolol (0.5%), pilocarpine (4%), epinephrine (2%), norepinephrine (2%), and ecothiophate iodide 0.125%). The results showed that epinephrine statistically decreased blood flow to the iris and ciliary processes while not to the posterior uveal tissues or optic nerve head. Pilocarpine also showed this same trend, while the differences were not statistically significant. Other drugs were without effect on regional ocular blood flow.  相似文献   

16.
A 25-year-old man with a rapidly progressive metastatic carcinoid tumour arising in the mediastinum developed a metastasis to the optic nerve. This is the first instance in the literature of an ocular metastasis from this variant of carcinoid tumour. The ocular pathology, ultrastructure, and recent information on the derivation of this tumour, believed to originate in the thymus, are presented.  相似文献   

17.
目的:评价肿瘤的位置、大小、组织学以及复发率。方法:前瞻性研究Larkana的Chandka医学院附属医院眼科的53例组织学诊断为视网膜母细胞瘤患者,肿瘤侵及眼球、眼眶、颅内以及其他组织。为研究肿瘤广泛性,检查包括:眼眶X线片,眼球B超,眼眶及头颅CT扫描/MRI,全骨扫描,胸部前后位X线片,腹部B超,腰椎穿刺,全血细胞计数,包括肝肾功能检查的血生化,根据肿瘤的位置、大小、复发及转移选择包括手术、局部放疗、系统化疗的治疗方案。有局部和系统转移的患者,由Larkana的核医学和放疗机构的肿瘤专家进行局部放疗和系统化疗。术后1,3,6,12mo复查随访,随后5a及5a以上,1a复查一次。评估肿瘤的位置、大小、组织类型和复发率。结果:患者53例,年龄8mo~8岁。男25例(47%),女28例(53%)。肿瘤的眼别,左眼25例(47%),右眼19例(36%),双眼9例(17%)。患者的首发症状,斜视3例(6%),假性眼内炎4例(8%),眼眶炎性假瘤6例(11%),转移性包块7例(13%),蕈样生长的包块8例(15%),白瞳征12例(23%),眼眶浸润13例(25%)。行单纯眼球摘除术19例(36%),行眼球摘除及改良型眶内容物剜除术并局部放疗和系统化疗19例(36%),行眼球摘除及完全型眶内容物剜除术并局部放疗和系统化疗15例(28%)。肿瘤的组织类型,含大量染色质的高分化视网膜母细胞瘤25例(47%),高度未分化视网膜母细胞瘤28例(53%)。首次手术后,由于手术切除点以上视神经受累,眼眶浸润和系统转移,发生复发和转移37例(70%)。结论:儿童红眼或白瞳征在确诊之前应怀疑视网膜母细胞瘤,应该及时经眼科专家检查,因为患者在肿瘤初期的早期表现提示会降低肿瘤的扩散、复发和死亡率。  相似文献   

18.
Cancer metastatic to the orbit: the 2000 Robert M. Curts Lecture   总被引:6,自引:0,他引:6  
PURPOSE: To report the demographics and clinical features of a large series of patients with orbital metastasis. METHODS: Retrospective chart review on 100 consecutive patients and a literature review on orbital metastasis. RESULTS: Of 100 patients, the primary tumor site was breast in 53 (53%), prostate gland in 12 (12%), lung in 8 (8%), skin (melanoma) in 6 (6%), kidney in 5 (5%), gastrointestinal tract in 5 (5%), choroid (melanoma) in 2 (2%), parotid gland in 1 (1%), and adrenal gland (neuroblastoma) in 1 (1%). Of patients in whom a detailed history was available, there was no history of cancer at the time of presentation in 19%. In 10%, the primary tumor remained undetected despite systemic evaluation. There were 36 male patients and 64 female patients whose mean age at diagnosis was 62 years (median 60 years, range 5 to 91 years). Both the right and left orbits were affected equally, and 4 cases (4%) were bilateral. The most frequent clinical findings were limited ocular motility (54%), proptosis (50%), and palpable mass (43%). The diagnoses were established by history, systemic survey, imaging studies, and biopsy. Treatment included chemotherapy, hormone therapy, irradiation, surgical excision, or observation, depending on clinical circumstances. Among patients with sufficient follow-up, 95% died of metastasis, with overall mean survival of 15 months (median 15 months; range 3 to 96 months) after orbital diagnosis. CONCLUSIONS: The most common primary cancers that metastasize to the orbit are breast, prostate gland, and lung cancer. In 19%, there is no history of cancer when the patient presents with ophthalmic symptoms and in 10% the primary site remains obscure despite systemic evaluation. The systemic prognosis is generally poor.  相似文献   

19.
PURPOSE: To evaluate the recent clinical manifestations of ocular complications in patients with human immunodeficiency virus(HIV) infection. METHODS: We retrospectively reviewed the medical records of 94 new HIV-positive patients examined at the International Medical Center of Japan between April 1, 2002, and March 31, 2003, and listed the details of ocular complications. The use of highly active antiretroviral therapy (HAART) and CD 4 cell counts was also recorded in patients with cytomegalovirus (CMV) retinitis and iritis/vitritis. RESULTS: The following ocular complications were recognized in 31 patients: retinal microvasculopathy (11 cases), CMV retinitis (10 cases), inactive inflammatory changes (6 cases), iritis/vitritis (5 cases), optic nerve atrophy (2 cases), papilledema (2 cases), ocular tuberculosis (1 case), progressive outer retinal necrosis (1 case) and conjunctival Kaposi's sarcoma (1 case). In patients with CMV retinitis, the CD 4 cell counts at the onset were lower than 50/microl except in 1 case. Iritis and/or vitritis were recognized in 5 cases, and the onset of 4 cases occurred after the beginning of HAART. Among the patients studied, immune recovery uveitis was suspected in 3 patients with a history of CMV retinitis. CONCLUSIONS: Ocular complications were recognized in almost one third of the patients in our series. Immune recovery uveitis was suspected in 3 patients with iritis/vitritis who previously had CMV retinitis.  相似文献   

20.
目的 探讨系统性红斑狼疮(SLE)眼底并发症的临床特点。 方法 回顾性分析25例出现眼底并发症的SLE患者的眼底、眼部其他表现、伴随的全身病变及血抗核抗体(ANA)、抗双链DNA(抗dsDNA)、补体3(C3)、 补体4(C4)和血红细胞沉降率(ESR)。 结果 “典型的”SLE眼底病变15例25只眼,视网膜静脉阻塞(RVO)9例12只眼,RVO合并视网膜动脉不全阻塞1例2只眼,渗出性视网膜脱离1例2只眼,玻璃体积血合并新生血管性青光眼1例1只眼,视盘水肿(除外RVO所 致)3例6只眼。9例合并有眼部其他表现,21例患者伴随有全身症状,所有病例血抗核抗体( ANA)、抗dsDN A阳性和血ESR升高,19例C3下降,17例C4下降。 结论 SLE可产生严重的 眼底并发症及合并其他眼部病变,对SLE患者应定期进行眼科检查,以便早期发现眼底病变 并及时进行治疗。 (中华眼底病杂志,2004,20:206-208)  相似文献   

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