眼後房腫瘤的診斷與治療

Diagnosis and Treatment of Ocular Posterior Segment Tumors

陳祐瑲(Yo-Chang Chen) ； 洪啟庭(Chi-Ting Horng) ； 林思源(Szu-Yuan Lin) ； 蔡明霖(Ming-Ling Tsai)

《中華民國眼科醫學會雜誌》 48卷2期 (2009/06) Pp. 111-120

https://doi.org/10.30048/ACTASOS.200906.0001

摘要

目的：對重要的眼後段腫瘤疾病進行文獻回顧。
方法：在PubMed資料庫上搜尋並理整自1976年至2009年間的相關文獻。關鍵字包括「ocular」、「tumors」、「intraocular tumors」相關詞及各種常見的治療方式名稱。
結果：根據眼後段腫瘤發生之病因，可大致分為系統性腫瘤(systemic tumors)、原發性腫瘤(primary tumors)及與系統性疾病相關之腫瘤(systemic diseases associated tumors)。常見的系統性腫瘤包括轉移性腫瘤(choroidal metastatic tumors)、淋巴瘤(lymphoma)及白血病(leukemia)；常見的原發性腫瘤，包括黑色素瘤(melanoma)、視網膜母細胞瘤(retinoblastoma)。常見與系統性疾病相關之腫瘤包括與希伯－林道症候群(von Hippel-Lindau syndrome)相關之視網膜血管母細胞瘤(retinal hemangioblastoma)、與Sturge-Weber症候群相關之脈絡膜血管瘤(choroidal hemangioma)、與結節性硬化症相關之視網膜星狀細胞缺陷瘤(astrocytic hamartoma)、與家族性大腸息肉症相關之先天性視網膜色素上皮肥大(CHRPE)。本文逐一介紹、討論上述疾病。
結論：眼後段腫瘤症狀多變且相互混淆，常構成臨床挑戰甚至進而損害病患之視力乃至生命；故臨床醫師應多加熟悉其診斷及處理。隨著診斷及治療的技術不斷突破，醫師更容易及早診斷並盡可能挽救眼後段腫瘤患者的視力及生命。

並列摘要

Purpose: A literature review of the important ocular posterior segment tumors.
Method: A PubMed search for English-language articles published between 1976 and 2009 was conducted. Search terms used were ”intraocular”, ”tumors” ocular tumors-related term, and the generic names of agents commonly used to treat intraocular tumors.
Results: According to the etiologies, the ocular posterior segment tumors can be divided into three groups. The first group had systemic tumors including choroidal metastatic tumors, lymphoma, and leukemia. The second group had primary tumors including melanoma and retinoblastoma. The last group had systemic disease associated tumors including retinal hemangiob-lastoma associated with von Hippel-Lindau syndrome, choroidal hemangioma associated with Sturge-Weber syndrome, astrocytic hamartoma associated with tuberous sclerosis, and congenital hypertrophy of the retinal pigment epithelium (CHRPE) associated with Gardner syndrome. We highlight recent developments in diagnosing and treating each intraocular disease process.
Conclusion: Ocular posterior segment tumors are usually challenging for clinicians and require detailed differential diagnosis between other simulating lesions. Clinicians should be familiar with the management of ocular posterior segment tumors, as some might be lethal and cause blindness. Recent advances in treatment and diagnosis are helpful for early diagnosis and prompt therapy to improve the prognosis of vision and overall life quality.

並列關鍵字

Ocular Posterior Segment Tumors ； choroidal tumors ； brachytherapy