Objective To probe the clinical character,the histopathological classification and misdiagnoses of intraocular tumors. Methods The clinical and pathological data of 359 patients with intraocular tumor diagnosed clinically between 1980～2000 were retrospectively analyzed. Results There were 300 cases of malignant tumor and 23 cases of benign tumor respectively. Non-oncologic malady and benign tumor misdiagnosed as tumor or malignant tumor were 40 cases. The two leading malignant tumors were retinoblastoma and melanoma. Conclusion The clinical and pathological analysis of intraocular tumor is beneficial to the correct clinical diagnosis and treatment. (Chin J Ocul Fundus Dis,2002,18:28-30)
Objective To observe the time-intensity curve characteristics of contrast agents in intraocular tumor. Methods A total of 236 patients (238 eyes) with intraocular tumor were enrolled in this study. All the patients received regular ophthalmologic examination, two dimensional ultrasound, color doppler ultrasonography and contrast-enhanced ultrasonography. There were 166 patients (166 eyes) with choroidal melanoma, 16 patients (18 eyes) with choroidal metastatic carcinoma, 52 patients (52 eyes) with choroidal hemangioma, two patients (two eyes) with retinal hemangioma. The whole process of contrast-enhanced ultrasound were recorded, and exported as t images of Dicom format. These images were processed by Sonoliver software (Tomteck Company, Germany) to drawn the time-intensity curve of contrast agents in the intraocular tumors. Results All intraocular lesions were completely filled with contrast agent, concentric filling from the periphery to the center can be documented in some cases. The time-intensity curve of choroidal hemangioma and retinal hemangioma were basically the same. The time-intensity curve of choroidal melanoma and choroidal metastatic carcinoma were also basically the same. In the filling phase, all tumors were rapid filling type. In the regression phase, contrast agent subsided earlier than in control tissue within the melanoma or metastatic carcinoma lesions, but subsided synchronous or slightly faster than in control tissue within the choroidal hemangioma and retinal hemangioma lesions. Among 166 eyes with choroidal melanoma, 138 eyes (83.1%) were in full compliance with the above changes, 28 eyes (16.9%) were largely in line with these changes. All the eyes (100.0%) with choroidal metastatic carcinoma, choroidal hemangioma and retinal hemangioma were in full compliance with the above changes. Conclusion Time-intensity curve is quickly filling and fast regression for malignant intraocular tumors, but is quickly filling and slow regression for benign intraocular tumors.
Objective To investigate the MRI characteristics of the tumor of optic pathway and damage degree of visual function. Methods Analysis of 119 cases surgically and pathologically proved tumor suffering from optic pathway was carried out retrospectively. The patients included:36 ones with tumors in anterior segment of optic pathway,70 ones in middle segment of optic pathway,and 13 ones in posterior segment of optic pathway. The MRI examination series were transverse T-1WI SE,transverse and coronal T-2WI TSE,coronal T-2WI SPIR,and transverse,sagittal,coronal T-1WI SE after Gd-DTPA enhancement. Results The tumors of optic pathway included:the primary tumors of the optic pathway and the tumors of any other part of the body which invaded the optic pathway. There was a special MRI feature on the each tumor suffering from optic pathway,but the pituitary adenoma which affects visual function was the most common tumor. Conclusion MRI is an effective method in the diagnosis of optic-pathway tumor. (Chin J Ocul Fundus Dis, 2002, 18: 101-103)
Objective To observe the classification,clinical and pathological features of ciliary body tumors. Methods The clinical and pathological data of 11 cases of primary ciliary body tumors were analysed retrospectively. Results By pathological examination,the tumors of these cases were devided into malignant melanoma (2 cases), benign melanocytoma (3 cases),leiomyoma (2 cases), and angio-leiomyoma, neurilemoma, non-special granuloma and medulloepithelioma (1 case respectively). Both of the benign and malignant tumors of ciliary body tended to grow and enlarge progressively. The cardinal clinical manifestations of this series of 11 cases were as follows: elevation of intraocular pressure in 7, local scleral vascular dilatation in 5, secondary exudative retinal detachment in 5,and the signs of anterior uveitis in the early stage of tumor growth in 4. Conclusion The histopathological types of cilliary tumors are manifold,and the tumors are prone to enlarge progressively in developement either in benign or malignant ones, so that the rates of clinical misdiagnosis are relatively high. (Chin J Ocul Fundus Dis, 2002, 18: 273-275)
Primary vitreoretinal lymphoma (PVRL) is a rare type of non-Hodgkin's lymphoma with poor prognosis and the optimal treatment has yet to be determined. Its treatment has evolved from enucleation to ocular radiotherapy, systemic chemotherapy and intravitreal chemotherapy. Radiotherapy can effectively eradicate tumor cells but ocular recurrences are common. Systemic chemotherapy has become the mainstream option but there are problems with only-partial response of PVRL and high rate of recurrence. Intravitreal chemotherapy, primarily used as adjunctive to systemic chemotherapy, has achieved high remission rate and low rate of recurrence as well as with limited ocular complications. The tumor cells were cleared and the visual function preserved. However, issues about the drug applied, treatment protocols and goals of intravitreal chemotherapy, whether for visual preservation or survival improvement, are worthy for further study.