■该研究的目的是描述和评估葡萄膜黑色素瘤眼肿瘤溶解综合征(OTLS)的特征。
■2009年至2021年科罗拉多大学所有OTLS患者的回顾性图表回顾。收集的数据包括患者人口统计学,肿瘤特征,辐射剂量测定,基因表达谱(GEP),OTLS特性,管理,和结果。
■接受I-125近距离放射治疗的7例葡萄膜黑色素瘤患者的7只眼睛出现OTLS。平均年龄为59岁(范围32-83)。平均根尖高度为8.6mm(范围6-11);平均直径为12.7mm(范围8.5-15.3)。所有肿瘤均用直径≥16mm的斑块治疗。在介绍时,5/7肿瘤有视网膜下液,和6/7有衣领按钮配置。OTLS在所有眼中都表现为玻璃体中广泛的色素分散,4/7眼视网膜下色素和/或视网膜脱离,2/7眼玻璃体出血,3/7眼的前房色素。四个肿瘤为GEP1类,两个为2类,一个未分类。4/7眼经巩膜活检,3/7眼经玻璃体活检。OTLS发生在5/7眼的眼内手术后2-4周。所有患者均接受了平坦部玻璃体切除术。玻璃体细胞学,在五个案例中获得,显示色素负载的巨噬细胞和出血,但只有1/5的眼睛有存活的恶性细胞。最后一次随访时四只眼睛稳定,两个被摘除了,一个人没有色素性青光眼的光感。6/7例出现视力不良(<20/200)。3例患者死于转移(肿瘤为GEP2类,GEP类无亚分类,且未进行GEP分类)。
■OTLS是葡萄膜黑色素瘤的一种罕见但破坏性的并发症。常见特征包括大斑块直径,视网膜下液的存在,和领扣形状。广泛分散的颜料通常不是恶性的。虽然视力不好很常见,大多数眼睛可以通过玻璃体视网膜手术修复避免摘除。
UNASSIGNED: The aim of the study was to describe and evaluate characteristics of ocular tumor lysis syndrome (OTLS) in eyes with uveal melanoma.
UNASSIGNED: Retrospective chart review of all patients with OTLS at the University of Colorado from 2009 to 2021. Data collected included patient demographics, tumor characteristics, radiation dosimetry, gene expression profiling (GEP), OTLS characteristics, management, and outcomes.
UNASSIGNED: Seven eyes of seven patients with uveal melanoma treated with I-125 brachytherapy developed OTLS. Average age was 59 years (range 32-83). Mean apical height was 8.6 mm (range 6-11); mean diameter was 12.7 mm (range 8.5-15.3). All tumors were treated with plaques ≥16 mm in diameter. On presentation, 5/7 tumors had subretinal fluid, and 6/7 had collar-button configuration. OTLS presented as extensive pigment dispersion in the vitreous in all eyes, subretinal pigment and/or retinal detachment in 4/7 eyes, vitreous hemorrhage in 2/7 eyes, and anterior chamber pigment in 3/7 eyes. Four tumors were GEP class 1, two were class 2, and one was unclassified. Biopsy route was trans-scleral in 4/7 eyes and trans-vitreal in 3/7 eyes. OTLS occurred 2-4 weeks after an intraocular procedure in 5/7 eyes. All underwent pars plana vitrectomy. Cytology of the vitreous, obtained in five cases, showed pigment laden macrophages and hemorrhage, but only 1/5 eyes had viable malignant cells. Four eyes were stable at the last follow-up, two were enucleated, and one had no light perception from pigmentary glaucoma. Poor vision (<20/200) occurred in 6/7 cases. Three patients died from metastasis (tumors were GEP class 2, GEP class without subclassification, and no GEP classification performed).
UNASSIGNED: OTLS is a rare but devastating complication of uveal melanoma. Common characteristics included large plaque diameter, presence of subretinal fluid, and collar-button shape. The extensively dispersed pigment is typically not malignant. Though poor vision is common, enucleation may be avoided in most eyes through vitreoretinal surgical repair.