Adult T-Cell Leukemia/Lymphoma-Related Ocular Manifestations: Analysis of the First Large-Scale Nationwide Survey
Adult T-Cell Leukemia/Lymphoma-Related Ocular Manifestations: Analysis of the First Large-Scale Nationwide Survey
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DOI：
10.3389/fmicb.2018.03240
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发表时间：
2019-01-08
影响因子：
5.2
通讯作者：
Ohno-Matsui, Kyoko
中科院分区：
文献类型：
--
作者：
Kamoil, Koju;Okayama, Akihiko;Ohno-Matsui, Kyoko
成人T细胞白血病/淋巴瘤（ATL）是一种罕见的、侵袭性的T细胞恶性肿瘤，死亡率很高，导致眼科医生缺乏相关信息。在这里，我们通过进行日本首次全国范围的大规模调查，调查了 ATL 和 ATL 相关眼部表现的眼科医疗状况。总共调查了 115 家机构，包括属于日本眼科学会会员的日本所有大学医院以及属于日本眼部炎症学会会员的地区核心机构。对收集到的全国范围内 ATL 相关眼部表现和 ATL 相关眼部检查结果的医疗保健状况数据进行了分类、统计和分析。在 115 家机构中，有 69 家 (60%) 做出了回应。总体而言，28 家机构 (43.0%) 拥有为 ATL 患者提供眼科护理的经验。 ATL 相关的眼部表现最常见的诊断是“根据血液检查和特征性眼科检查结果”。通过分析48例报告的ATL相关眼部表现，常见的ATL相关眼部病变为眼内浸润（22例，45.8%）和机会性感染（19例，39.6%）。所有机会性感染病例均为巨细胞病毒性视网膜炎。还可见干眼（3例，6.3%）、巩膜炎（2例，4.2%）、葡萄膜炎（1例，2.1%）和贫血性视网膜病变（1例，2.1%）。总之，眼内浸润和巨细胞病毒性视网膜炎在 ATL 患者中很常见，眼科医生在实践中应牢记这些发现。
Adult T-cell leukemia/lymphoma (ATL) is a rare and aggressive T-cell malignancy with a high mortality rate, resulting in a lack of information among ophthalmologists. Here, we investigated the state of ophthalmic medical care for ATL and ATL-related ocular manifestations by conducting the first large-scale nationwide survey in Japan. A total of 115 facilities were surveyed, including all university hospitals in Japan that were members of the Japanese Ophthalmological Society and regional core facilities that were members of the Japanese Ocular Inflammation Society. The collected nationwide data on the state of medical care for ATL-related ocular manifestations and ATL-associated ocular findings were categorized, tallied, and analyzed. Of the 115 facilities, 69 (60%) responded. Overall, 28 facilities (43.0%) had experience in providing ophthalmic care to ATL patients. ATL-related ocular manifestations were most commonly diagnosed "based on blood tests and characteristic ophthalmic findings." By analyzing the 48 reported cases of ATL-related ocular manifestations, common ATL-related ocular lesions were intraocular infiltration (22 cases, 45.8%) and opportunistic infections (19 cases, 39.6%). All cases of opportunistic infection were cytomegalovirus retinitis. Dry eye (3 cases, 6.3%), scleritis (2 cases, 4.2%), uveitis (1 case, 2.1%), and anemic retinopathy (1 case, 2.1%) were also seen. In conclusion, intraocular infiltration and cytomegalovirus retinitis are common among ATL patients, and ophthalmologists should keep these findings in mind in their practice.