视神经鞘脑膜瘤诊治中的误区与争议  

Misunderstandings and controversies in the diagnosis and treatment of optic nerve sheath meningioma

作　　者：刘祎 姜利斌 Liu Yi;Jiang Libin(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,100730

出　　处：《中华眼底病杂志》2021年第10期817-820,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：首都卫生发展科研专项基金(2020-2-1082)。

摘　　要：视神经鞘脑膜瘤(ONSM)约占所有脑膜瘤的1%~2%,多为良性,疾病进展缓慢。ONSM是临床上相对少见的眶内良性肿瘤,由于与视神经关系密切,其诊断和治疗具有特殊性,因此在其诊疗中存在着较多的争议和误区。由于ONSM某些临床特征与其他性质视神经疾病如视神经炎相类似,常被误诊为急性视神经乳头炎、视神经萎缩、缺血性视神经病变、急性球后视神经炎、视盘血管炎或视疲劳等。其治疗方式包括随访观察、手术治疗和放射治疗,不同患者应根据病情的变化,选择合适的治疗手段。因此,深入了解视神经鞘脑膜瘤诊治中存在的争议和误区,对于及时作出准确的诊断,采用合适的治疗方法,改善患者的预后具有重要的临床意义。Optic nerve sheath meningiomas(ONSM)account for about 1%-2%of all meningiomas.Most of them are benign and the disease progresses slowly.ONSM is a relatively rare intraorbital benign tumor in clinical practice.Due to its close relationship with the optic nerve,the diagnosis and treatment are special,so there are many controversies and misunderstandings in the diagnosis and treatment of ONSM.ONSM is often misdiagnosed as acute optic nerve papillitis,optic nerve atrophy,ischemic optic neuropathy,acute retrobolic optic neuritis,optic disc vasculitis or optic fatigue due to its similar clinical features to other optic nerve diseases such as optic neuritis.The treatment includes observation,surgical treatment and radiotherapy,and appropriate treatment should be selected for different patients according to the changes of their condition.Therefore,understanding of the controversies and misunderstandings in the diagnosis and treatment of ONSM is of great clinical significance for timely and accurate diagnosis,appropriate treatment and improvement of the prognosis of patients.

关 键 词：视神经肿瘤 诊断 治疗 综述 

分 类 号：R739.45[医药卫生—肿瘤]