睫状体肿瘤8例临床分析  

Clinical analysis of 8 patiens with ciliary body tumours

作　　者：马倩南 李静 李玉文 柳睿 马建民 Ma Qiannan;LiJing;Li Yuwen;Liu Rui;Ma Jianmin(Clinical Medical School,Shandong Second Medical University,Weifang 261053,China;Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing 100730,China)

机构地区：[1]山东第二医科大学临床医学院,潍坊261053 [2]首都医科大学附属北京同仁医院,北京同仁眼科中心,眼科学与视觉科学北京市重点实验室,北京100730

出　　处：《中华眼底病杂志》2024年第11期833-839,共7页Chinese Journal of Ocular Fundus Diseases

基　　金：北京市自然科学基金(7222025);北京市科技新星计划交叉合作课题(20220484218);北京市医院管理中心“登峰”计划(DEL20190201)。

摘　　要：目的观察睫状体肿瘤的临床特征、治疗方法和预后。方法回顾性临床研究。2011年11月至2023年3月于北京同仁医院眼肿瘤科经病理组织学检查证实的睫状体肿瘤8例8只眼纳入研究。详细采集患者年龄、性别、受累眼别、症状、最佳矫正视力(BCVA)、眼压、白内障、晶状体半脱位、影像表现。所有患眼均行手术治疗。手术后随访时间1~10年。回顾分析患者临床表现以及影像学、病理组织学特征和治疗方法、预后。结果8例8只眼中,男性3例3只眼,女性5例5只眼;右眼、左眼分别为3、5只眼。中位年龄44岁。睫状体髓上皮瘤、黑色素瘤、鳞状细胞癌、平滑肌瘤、神经鞘瘤、睫状体无色素上皮腺瘤分别为2、2、1、1、1、1只眼。所有患者均主述视力下降或丧失。伴有白内障、玻璃体混浊、眼红和(或)眼痛、视网膜脱离、晶状体半脱位、继发性青光眼分别为6、4、4、2、1、1只眼。影像学诊断与病理诊断结果一致3只眼。首次手术行眼球摘除、义眼台植入2只眼,患者年龄分别为9、10岁,均为髓上皮瘤;手术后随访时间分别为1、5年。行局部肿瘤切除手术6只眼,其中良性肿瘤3只眼,手术后随访时间1~9年;恶性肿瘤3只眼,手术后随访时间2~7年。良性肿瘤3只眼中,视力明显改善2只眼,其中无色素上皮腺瘤1只眼BCVA由手术前数指/1 m提升至手术后0.5,平滑肌瘤1只眼BCVA由手术前0.06提升至手术后0.5;失访1只眼。恶性肿瘤3只眼中,手术后复发2只眼(手术后随访时间分别为2、4年),再次分别行眼球摘除、局部肿瘤切除联合局部冷冻治疗各1只眼;手术后未复发1只眼,但随访期间视力无明显改善。所有患眼末次随访时肿瘤均无复发或转移。结论睫状体肿瘤类型和临床表现复杂多样;影像学检查可以发现肿瘤但对病变性质判断不佳。良性肿瘤局部切除手术效果好;恶性肿瘤眼球摘除效果好。Objective To observe the clinical features,treatment and prognosis of ciliary body tumors.Methods A retrospective clinical study.From November 2011 to March 2023,8 cases(8 eyes)with ciliary body tumours confirmed by pathohistological examination at the Department of Ocular Oncology,Beijing Tongren Hospital were included in the study.Patients'age,gender,involved eyes,symptoms,best corrected visual acuity(BCVA),intraocular pressure,cataract,lens subluxation,and imaging manifestations were collected in detail.All affected eyes were treated surgically.The follow-up time after surgery ranged from 1 to 10 years.The patients'clinical presentation as well as imaging,pathohistological features and treatment and prognosis were analysed retrospectively.ResultsAmong 8 cases(8 eyes),there were 3 males(3 eyes)and 5 females(5 eyes),3 and 5 eyes in the right and left eyes,respectively.The median age was 44 years.Ciliary body medulloepitheliomas,melanoma,squamous cell carcinoma,leiomyoma,schwannoma,and adenoma of the nonpigmcnted ciliary epithelium were in 2,2,1,1,1,and 1 eyes,respectively.All reported decreased or loss of vision.Cataract,vitreous opacity,red eye and or(ocular pain),retinal detachment,lens subluxation,and secondary glaucoma were 6,4,4,2,1,and 1 eyes,respectively.Diagnostic imaging was consistent with pathological findings in 3 eyes. The first surgery was performed for enucleation and orbital implantation in 2eyes, the patients were 9 and 10 years old with medullary epithelioma;the follow-up time after surgery was 1 and5 years, respectively. Local tumour resection was performed in 6 eyes. Among them, 3 eyes with benign tumourswere followed up for 1 to 9 years after surgery;2 eyes showed significant improvement in visual acuity, 1 eyewith adenoma of the nonpigmcnted ciliary epithelium had a preoperative BCVA of finger count/1 m, and apostoperative BCVA of 0.5, and 1 eye with leiomyoma had a preoperative BCVA of 0.06, and a postoperativeBCVA of 0.5;and 1 eye was lost to follow-up. Malignant tumour in 3 eyes, of whic

关 键 词：睫状体肿瘤 诊断 治疗 预后 

分 类 号：R739.7[医药卫生—肿瘤]