小细胞肺癌可能通过转移性增殖直接影响眼睛,或通过副肿瘤综合征间接影响眼睛。脉络膜是葡萄膜转移最常见的部位(90%);然而,虹膜受累的病例比例较小(发生率<10%).视力模糊,疼痛,发红,畏光,青光眼,前房积血和视野缺损可由这种转移性受累引起。据报道,虹膜转移患者的中位生存时间为4个月。继发性青光眼可以通过局部和口服治疗来治疗,经巩膜睫状体光凝,激光小梁成形术,抗VEGF,微创青光眼手术(MIGS),过滤手术,分流手术或摘除。介绍了一例伴有虹膜转移的原发性小细胞肺癌。转移产生了闭角型青光眼,局部治疗难以治疗。局部放疗,得到当地良好的回应。
Small-cell lung cancer may directly affect the eye by metastatic proliferation or indirectly by paraneoplastic syndromes. The choroid is the most common site for uveal metastasis (90%); however, the iris can be involved in a smaller proportion of cases (incidence <10%). Blurred vision, pain, redness, photophobia, glaucoma, hyphema and visual field defects can arise from this metastatic involvement. The median survival time for patients with iris metastasis is reported to be 4 months. Secondary glaucoma can be managed with topical and oral treatment, transscleral cyclophotocoagulation, laser trabeculoplasty, anti-VEGF, Minimally Invasive Glaucoma Surgery (MIGS), filtering surgery, shunting surgery or enucleation. A
case of primary small-cell lung cancer with iris metastasis is presented. The metastases produced an angle-closure glaucoma, which was refractory to topical treatment. Local radiotherapy was administered, obtaining a good local response.