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NR 1-2/2004
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Wtórne odwarstwienie
siatkówki towarzyszące wewnątrzgałkowym guzom złośliwym
Secondary retinal detachment
accompanying intraocular tumors
Jarosław Kocięcki1, Wiesława
Biczysko2, Abdul Walki Alugail1
1 Z Katedry i Kliniki Okulistycznej Akademii
Medycznej im. Karola Marcinkowskiego w Poznaniu
Kierownik: prof. dr hab. n. med. Krystyna Pecold
2 Z Zakładu Patomorfologii Klinicznej Akademii
Medycznej im. Karola Marcinkowskiego w Poznaniu
Kierownik: prof. dr hab. n. med. Wiesława Salwa-Żurawska |
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| Summary: |
Purpose: Aim of the
study – the attempt to answer, what is the present
incidence mechanism of arising, and what parameters can
influence the development of secondary retinal
detachment (s. r. d.) caused by intraocular choroidal
tumor.
Material and metod: 107 eyes of 105 consecutive
patients aged 21 to 82 years (mean 62 years), diagnosed
clinically as having choroidal malignant tumor, were
evaluated. All patients were examined clinically
including examination of anterior segment and fundus,
ultrasonography and fluorescein angiography of the eye.
Eyes qualified for enucleation were also examined
histopathologically.
Results: Out of all evaluated eyes s. r. d. was
observed in 27 eyes (26 cases – 25%). Exclusively in
this group it occurred in 16 women (62%) and 10 men
(38%). Right eye was involved in 10 cases, left eye in
15 and in 1 case both eyes were involved. The cause of
s. r. d. was primary malignant choroidal tumor and in 3
cases – metastatic tumor. The therapy included
brachytherapy, diode laser transpupillary thermotherapy
(TTT), chemiotherapy, local tumor excision and combined
treatment. The s. r. d. was observed in cases of small
tumors (2,77 mm) as well as very large ones (up to 11,56
mm). After therapy the detachment conceded in 10 eyes
(37%). Analysis of clinical images, fluorescein
angiograms and histopathological evaluation enabled
better understanding of mechanisms leading to s. r. d.
Conclusions: 1. In evaluated group the s. r. d.
occurred more often in women (62%) than in men (38%). 2.
Like intraocular tumors – it was seen more often in the
left eye (59%) than in right one (41%). 3. The s. r. d.
may occur in large tumors (over 6 mm) as well as in
small ones (3 mm). 4. In case of large tumors the
detachment has mainly „mechanical” character, however it
may be also influenced by increased permeability of
tumor vessels and impaired function of retinal pigment
epithelium; the latter mechanism seems to play the main
role in case of small tumors; in both cases the external
retinal layer is damaged. 5. The most common cause of s.
r. d. are tumors located in posterior pole (45%) and
least frequently in upper-temporal quadrant (7%). 6.
After brachytherapy, TTT or local tumor excision in
selected cases s. r. d. may totally regress. |
| Słowa kluczowe: |
laser diodowy,
termoterapia przezźreniczna, guzy wewnątrzgałkowe,
odwarstwienie siatkówki, hipertermia, brachyterapia.
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| Key words: |
diode laser,
transpupillary thermotherapy, intraocular tumors,
retinal detachment, hyperthermia, brachytherapy. |
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