Uveal effusion syndrome caused by choroidal invasion of malignant lymphoma
Uveal effusion syndrome caused by choroidal invasion of malignant lymphoma
复制标题
恶性淋巴瘤侵犯脉络膜所致葡萄膜积液综合征
DOI：
10.1007/s10384-009-0757-5
复制
发表时间：
2010
期刊：
影响因子：
2.4
通讯作者：
Ohno S.
中科院分区：
文献类型：
--
作者：
Kase S;Saito W;Saito A;Ohno S.
讨论本例纤毛脉络膜积液，病理组织学显示淋巴瘤细胞浸润至深脉络膜及结膜下。眼显像示脉络膜钆弥漫性增强，巩膜略薄。吲哚菁绿血管造影未见脉络膜中、大血管异常。这些结果提示，葡萄膜积液是由于淋巴瘤细胞侵入脉络膜静脉深层（包括漩涡静脉壶腹），并进一步上游进入筋膜内漩涡静脉而引起的机械循环障碍引起的。我们的病人表现出明显的高IOP和患眼闭合角。继发性UES患者可发展窄角型青光眼3,4，这与原发性UES无关。IOP升高的机制被认为是由于纤毛脉络膜积液导致纤毛体前旋导致的闭角。的确，化疗后葡萄膜积液完全消除，IOP正常化，前房加深成开放角度，提示恶性淋巴瘤侵袭脉络膜可导致UES。
DiscussionIn this case of ciliochoroidal effusion, invasion of lymphoma cells into the deep choroid and subconjunctiva was demonstrated histopathologically. Ocular imaging revealed that the choroid was diffusely enhanced by gadolinium, but the sclera was slightly thin. Indocyanine green angiography revealed no abnormality of mid-sized to large vessels of the choroid. These findings suggest that the uveal effusion was caused by a mechanical circulation disorder resulting from lymphoma cell invasion into the deep layer of choroidal veins, including the ampullae of vortex veins, and, further upstream, into the intrascleral vortex veins. Our patient showed markedly high IOP with a closed angle in the affected eye. Patients with secondary UES can develop narrow-angle glaucoma, 3, 4 which is not associated with primary UES. 1 The mechanism underlying the increased IOP is believed to be a closed angle caused by anterior rotation of the ciliary body as a result of ciliochoroidal effusion. Indeed, uveal effusion completely resolved, IOP normalized, and the anterior chamber deepened with an opened angle after chemotherapy, indicating that choroidal invasion of malignant lymphoma can lead to UES.