摘要
目的 观察眼内淋巴瘤患者化学药物治疗(简称化疗)后的眼底变化。方法 回顾性分析2015-01至2021-12就诊于解放军总医院第一医学中心眼科的11例(15眼)眼内淋巴瘤患者,其中男7例,女4例,年龄47~67岁,平均55.9岁,观察化疗后眼底变化。结果 11例给予眼部局部化疗或联合全身治疗后眼部淋巴瘤消退效果良好,观察至今(随访截至2022-05)未出现中枢神经系统受累。2年内发生化疗相关性视网膜病变7例(7眼),视神经病变7例(9眼)给予眼部相关对症治疗后,1年内眼底未见进展性变化,病情稳定;3例(6眼)全身其他部位确诊淋巴瘤化疗后,1年内确诊化疗相关性视神经病变及化疗相关视网膜病变,给予眼科对症治疗,观察1年眼底肿瘤未见进展性病变,病情稳定;1例(1眼)全身其他部位确诊淋巴瘤,化疗后1年内单眼视网膜特发性出血,给予眼科对症治疗,观察1年,眼底未见进展性病变。结论 全身淋巴瘤合并眼内淋巴瘤患者无论眼内单纯化疗或者眼内局部化疗联合全身化疗后,容易合并化疗性视神经视网膜病变,给予眼部及全身对症治疗可稳定或减缓病变的发生和进展,减少中枢神经受累。
Objective To observe the fundus characteristics and changes of patients with intraocular lymphoma after chemotherapy.Methods A retrospective analysis of 11 patients(15 eyes) with intraocular lymphoma who were treated in the Department of Ophthalmology of the First Center of Chinese PLA General Hospital from January 2015 to December 2021 involved 7 males and 4 females, ranging in age from 47 to 67, with an average age of 55.9.Results Eleven patients(11 eyes) were diagnosed with lymphoma at other sites combined with intraocular lymphoma. After local chemotherapy or combined systemic treatment, ocular lymphoma has a good atrophy effect, and no central nervous system involvement has been observed so far. Chemotherapy-related retinopathy occurred in 7 patients(7 eyes) and optic neuropathy in 7 patients(9 eyes) within 2 years. No progressive changes were observed in fundus for 1 year after symptomatic treatment, and the condition was stable. Three patients(6 eyes) were diagnosed with lymphoma at other sites and received chemotherapy. Chemotherapy-associated optic neuropathy and chemotherapy-associated retinopathy were diagnosed within 1 year. The patients were followed up for 1 year after symptomatic treatment. Fundus lesions did not progress and the condition was stable. One patient(1 eye) developed idiopathic retinal hemorrhage in one eye within 1 year after diagnosis of lymphoma elsewhere and received chemotherapy. Symptomatic ophthalmologic treatment was given. During the 1-year follow-up, the fundus lesions did not progress and the condition was stable.Conclusions The incidence of chemotherapeutic optic neuroretinopathy is very high in patients with systemic lymphoma combined with intraocular lymphoma, whether receiving intraocular chemotherapy or intraocular chemotherapy combined with systemic chemotherapy. Eye and systemic symptomatic treatment can stabilize or slow down the occurrence and progression of the fundus lesions and reduce central nervous involvement.
作者
李莹
张鸿瑫
LI Ying;ZHANG Hongtao(Senior Department of Ophthalmology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Eye Institute,Senior Department of Ophthalmology,the Third Medical Center of Chinese PLA General Hospital,Beijing 100039,China)
出处
《武警医学》
CAS
2023年第1期22-25,共4页
Medical Journal of the Chinese People's Armed Police Force
