鼻咽癌患者輻射性視網膜病變的臨床觀察

Clinical Observation of Radiation Retinopathy in Nasopharyngeal Carcinoma Patients

楊中美(Chung-Mei Yang) ； 陳慕師(Muh-Shy Chen) ； 柯良時(Liang-Shi Ko)

《中華民國眼科醫學會會刊》 27卷2期 (1988/05) Pp. 842-848

https://doi.org/10.30048/ACTASOS.198805.0147

摘要

收集自民國67年至民國77年，在台大眼科門診診斷為幅射線視網膜病變之鼻咽癌患共17名，九男八女。觀察其臨床特徵及變化。病患均曾於台大醫院接受過放射線治療，追踪時期除兩例外均大於等於六個月。
研究結果顯示其典型之臨床變化包括：(1)病變多局限在後極部，黃斑部通常最受影響。(2)眼底變化可見從小血管之封阻伴隨局部之微血管瘤、小血管擴張，中心凹微血管環之缺損及黃斑部水腫。(3)病變通常兩側發生，但不一定對稱。(4)病變經過長期仍頗為穩定。(5)若出現廣大之無血管灌流區則易生新生血管及玻璃體出血，造成視力不良。

並列摘要

For studying the clinical pictures and the natural course of radiation retinopathy in NPC patients, 17 patients, 9 male, 8 female, diagnosed as such disease in our department from 1978 to 1 988 were reviewed. All the patients had received radiotherapy in our hospital. V.A. examination, biomicroscopy, fundus examination and FAG were done on the initial and follow-up visits. Average follow-up period was 30 months.
Typical clinical changes in these patients includes:
(1) The lesions are usually confined to the posterior pole with macula most affected.
(2) Capillary occlusion with localized microaneurysm, telangiectasis, broken perifoveal capillary network and macular edema.
(3) Bilateral but may be asymmetrical involvement.
(4) The lesions are rather stationary.
(5) Broken perifoveal capillary network and macular edema do not necessarily indicate poor V.A.
(6) Extensive nonperfusion area always had poor visual outcome.
The implications of these manifestation on the treatment was discussed.

並列關鍵字

Radiation Retinopathy ； Nasopharyngeal Carcinoma