重视睫状体肿瘤的正确诊断及合理治疗

Pay attention to the correct diagnosis and rational treatment of ciliary body tumors

睫状体肿瘤是一种罕见的眼内肿瘤,由于独特的解剖位置,使其正确诊断及合理治疗成为非常棘手的问题。诊断及鉴别诊断方面,眼科医生需充分发挥裂隙灯显微镜及透照试验的作用,捕捉隐蔽的睫状体肿瘤引起的眼前节继发性改变,如单眼局限性白内障、晶状体压迹、色素播散等,并结合眼科影像学检查,尤其是超生生物显微镜,达到早发现、早诊断的目的。根据肿瘤的大小、位置和形态特点,制定合理的治疗方案。由于睫状体肿瘤良性居多,局部睫状体切除手术治疗复发率低,能够满足病理诊断,且能保留患者部分视力,因此应主张保眼球治疗。但对于肿瘤太大而无法通过局部切除或放射治疗的肿瘤、患有顽固性青光眼以及对放射治疗无反应的肿瘤,眼球摘除仍然是需要选择的治疗方法。

Ciliary body tumor is a rare intraocular tumor.Due to its unique anatomical location,its correct diagnosis and reasonable treatment are very difficult problems.In terms of diagnosis and differential diagnosis,ophthalmologists need to fully utilize the role of slit lamp microscope and transillumination experiment to capture secondary changes in the anterior segment caused by hidden ciliary body tumors,such as monocular localized cataract,lens indentation,and pigment dissemination,etc.Ophthalmological imaging methods,especially ultrasound biomicroscopy,can achieve the purpose of early detection and early diagnosis.According to the size,location and morphological characteristics of the tumor,a reasonable treatment plan is formulated.Since ciliary body tumors are mostly benign,the recurrence rate of local resection is low,which can satisfy the pathological diagnosis and preserve part of the patient's vision.Therefore,eye-preserving treatment should be advocated.However,enucleation remains the treatment of choice for tumors that are too large to be treated with local excision or radiation,eyes with refractory glaucoma,and tumors that do not respond to radiation therapy.