中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
6期
731-734
,共4页
眼眶肿瘤%甲状腺相关眼病%眼眶炎性假瘤%眼底%脉络膜视网膜皱褶
眼眶腫瘤%甲狀腺相關眼病%眼眶炎性假瘤%眼底%脈絡膜視網膜皺褶
안광종류%갑상선상관안병%안광염성가류%안저%맥락막시망막추습
Orbital tumor%Thyroid associated ophthalmopathy%Orbital inflammatory pseudotumor%Fundus%Choroidal retinal folds
目的 探讨眼眶疾病合并眼底改变的临床特征以及二者的关系.方法 回顾分析合并眼底改变的18例眼眶疾病,其中甲状腺相关眼病3例,眼眶炎性假瘤2例,泪腺多形性腺瘤3例,眼眶视神经胶质瘤2例,视神经脑膜瘤2例,眼眶神经鞘瘤l例,眼眶副神经节瘤1例,眼眶非霍奇金淋巴瘤l例,眼眶海绵状血管瘤1例,眼眶脉管瘤并出血1例,后巩膜炎l例.结果 18例眼眶疾病的患眼均有不同程度的眼底改变.甲状腺相关眼病的眼底特征为视盘瘀血性水肿和黄斑皱褶；眼眶炎性假瘤的眼底特征为视盘水肿炎症；眼眶肿瘤的眼底改变表现为肿瘤压迫导致的脉络膜视网膜皱褶和隆起；若肿瘤位于视神经则易合并视乳头肿胀改变；累及眶尖部位则易形成眶内血液回流障碍,出现明显的眼底视网膜静脉扩张迂曲.结论 眼眶疾病引起的眼底改变主要为眶内肿物轻度压迫引起的脉络膜视网膜皱褶和明显压迫引起的脉络膜视网膜局部隆起；当眶内病变累及球后近端视神经则易导致视乳头肿胀,累及眶尖部位则易出现视网膜静脉扩张迂曲.眶内疾病合并眼底改变可能与其原发疾病性质、位置有关.
目的 探討眼眶疾病閤併眼底改變的臨床特徵以及二者的關繫.方法 迴顧分析閤併眼底改變的18例眼眶疾病,其中甲狀腺相關眼病3例,眼眶炎性假瘤2例,淚腺多形性腺瘤3例,眼眶視神經膠質瘤2例,視神經腦膜瘤2例,眼眶神經鞘瘤l例,眼眶副神經節瘤1例,眼眶非霍奇金淋巴瘤l例,眼眶海綿狀血管瘤1例,眼眶脈管瘤併齣血1例,後鞏膜炎l例.結果 18例眼眶疾病的患眼均有不同程度的眼底改變.甲狀腺相關眼病的眼底特徵為視盤瘀血性水腫和黃斑皺褶；眼眶炎性假瘤的眼底特徵為視盤水腫炎癥；眼眶腫瘤的眼底改變錶現為腫瘤壓迫導緻的脈絡膜視網膜皺褶和隆起；若腫瘤位于視神經則易閤併視乳頭腫脹改變；纍及眶尖部位則易形成眶內血液迴流障礙,齣現明顯的眼底視網膜靜脈擴張迂麯.結論 眼眶疾病引起的眼底改變主要為眶內腫物輕度壓迫引起的脈絡膜視網膜皺褶和明顯壓迫引起的脈絡膜視網膜跼部隆起；噹眶內病變纍及毬後近耑視神經則易導緻視乳頭腫脹,纍及眶尖部位則易齣現視網膜靜脈擴張迂麯.眶內疾病閤併眼底改變可能與其原髮疾病性質、位置有關.
목적 탐토안광질병합병안저개변적림상특정이급이자적관계.방법 회고분석합병안저개변적18례안광질병,기중갑상선상관안병3례,안광염성가류2례,루선다형성선류3례,안광시신경효질류2례,시신경뇌막류2례,안광신경초류l례,안광부신경절류1례,안광비곽기금림파류l례,안광해면상혈관류1례,안광맥관류병출혈1례,후공막염l례.결과 18례안광질병적환안균유불동정도적안저개변.갑상선상관안병적안저특정위시반어혈성수종화황반추습；안광염성가류적안저특정위시반수종염증；안광종류적안저개변표현위종류압박도치적맥락막시망막추습화륭기；약종류위우시신경칙역합병시유두종창개변；루급광첨부위칙역형성광내혈액회류장애,출현명현적안저시망막정맥확장우곡.결론 안광질병인기적안저개변주요위광내종물경도압박인기적맥락막시망막추습화명현압박인기적맥락막시망막국부륭기；당광내병변루급구후근단시신경칙역도치시유두종창,루급광첨부위칙역출현시망막정맥확장우곡.광내질병합병안저개변가능여기원발질병성질、위치유관.
Objective To observe the clinical characteristics of fundus changes secondary to orbital diseases and to find out the relationship between the fundus lesions and orbital diseases.Methods A retrospective review of 18 cases of orbital diseases that showed remarkable orbit-related fundus changes and were seen by the corresponding author in Zhongshan Ophthalmic Center,Sun Yat-sen University,from Feb 2001 to Sep 2009.These included 3 cases of thyroid associated ophthalmopathy (TAO),2 cases of idiopathic orbital inflammatory pseudotumor (IOIP),3 cases of pleomorphic adenoma of lacrimal gland,2 cases of optic nerve glioma,2 cases of meningioma of optic nerve,1 case of orbital neurilemmoma,1 case of orbital paragangliomas,1 ease of orbital non-hodgkin's lymphoma,1 ease of vascular malformation with orbital bleeding,and 1 case of posterior scleratitis.Results All 18 cases with orbital diseases had their fundus changes.The fundus features in patients with TAO were congestive papilledema and macular pucker; those in IOIP were inflammatorypapilledema.In patients with orbital tumors,the main findings were choroidal-retinal folds and/or uplift due to direct tumor compression.If tumors were near or next to the optic nerve,they were easy to have papilledema; if the mass involved the orbital apex,they were easy to result in blood backflow obstacles and showed apparent retinal vein expansion.Conclusions Main fundus changes in patients with orbital diseases are choroidal-retinal folds due to mild tumor compression and local choroidal-retinal uplift due to obvious tumor onmpressior.Orbital lesions involving the proximal optic nerve may result in papilledema and those involving orbital apex may block the blood backflow and show apparent retinal vein expansion.The fundus changes secondary to diseases of the orbit related probably to the properties and location of primary diseases.
