Turkiye Klinikleri Journal of Ophthalmology

.: REVIEW
İntraoküler Tümörler ve Glokom
Intraocular Tumors and Glaucoma
Elif Betül TÜRKOĞLUa, Berkay Öner KARACAa, İclal YÜCELa
aGöz Hastalıkları ABD, Akdeniz Üniversitesi Tıp Fakültesi, Antalya, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2019;28(4):288-93
doi: 10.5336/ophthal.2019-65733
Article Language: TR
Full Text
ÖZET
 İntraoküler tümörler, glokomun nadir sebepleri arasında olsa da sebebi açıklanamayan glokom hastalarında mutlaka düşünülmelidir. Benign, malign, primer veya metastatik intraoküler tümörler nedeni ile glokom oluşabilmektedir. Tanıda ve tedavide ortaya çıkan zorluklar nedeni ile intraoküler tümörlerin glokom ile ilişkisi bilinmelidir. Glokom gelişen hastalarda oluşum mekanizması, tedavi ve prognoz tümörün tipine ve yerleşim yerine göre farklılıklar göstermektedir. Literatür incelendiğinde; daha sıklıkla melanoma, melanositoma, iris nevüsleri, retinoblastoma, medulloepitelyoma, juvenil ksantogranüloma, lösemi, lenfoma, metastatik tümörler, Sturge Weber Sendromu ve Nörofibromatozis nedeni ile oluşan glokom hastaları tanımlanmıştır. Patofizyolojide açıya direkt invazyon, pigment dispersiyonu, melanofajik, hemolitik, üveitik, açı kapanması, neovaskülarizasyon, hemoraji, iris lens diyaframının anterior deplasmanı gibi birçok mekanizma yer almaktadır. İntraoküler tümörlerin kendisi glokoma neden olabileceği gibi, tümöre yönelik tedavi de glokoma sebep olabilir. Tümörleri her zaman biyomikroskobik inceleme ile tanımak mümkün değildir. Tanıya yardımcı olarak ön segment optik kohorens tomografi, ultrasonik biyomikroskopi ve radyolojik tetkikler (BT/MR/PET-BT) de kullanılmaktadır. Tedavide farmakolojik ajanlar, lazer, cerrahi girişimler, intravitreal anti-vasküler endotelyal büyüme faktörü uygulaması ve radyoterapi ele alınmıştır. Bu çalışmada, konu ile ilgili literatür göz önünde bulundurularak, intraoküler tümörlerin glokom oluşturma mekanizmaları anlatılıp tanıda kullanılan tetkikler ve tedavide izlenecek stratejiler incelenmiştir. Doğru tanı ve tedavi ile intraoküler tümör nedeni ile oluşan glokom hastalarında hem görme düzeylerinin korunması hem de yaşam süresinin uzatılması amaçlanmaktadır.

Anahtar Kelimeler: Onkoloji; neovaskülarizasyon; glokom
ABSTRACT
 Intraocular tumors are rare causes of glaucoma, and in cases of unexplained glaucoma, the possibility of an intraocular tumor must be considered. Glaucoma is associated with benign, malign, primary and metastatic intraocular tumors. Because of the difficulties in diagnosis and treatment, the relation between intraocular tumors and glaucoma should be known. Mechanism of glaucoma, treatment options and prognosis varies according to tumor type and location. In the literature, glaucoma due to melanoma, melanocytoma, iris nevi, retinoblastoma, medulloepithelioma, juvenil xanthogranuloma, leukemia, lymphoma, metastatic tumors, Sturge Weber syndrome and neurofibromatosis have been described. There are many mechanisms such as direct invasion to angle, pigment dispersion, melanophagic, hemolytic, uveitic, angle closure, neovascularization, hemorrhage, anterior displacement of iris lens diaphragm in pathophysiology. Treatment of intraocular tumors can also cause secondary glaucoma. Tumors are not always able to be recognized by examination. Anterior segment Optic Cohorence Tomography, ultrasonic biomicroscopy, and radiological imaging can be use to diagnose. Pharmacological agents, laser, surgical interventions intravitreal antivascular endothelial growth factor enjection and radiotherapy for treatment are discussed. In this review, the mechanism of glaucoma secondary to intraocular tumors, diagnostic tecniques and treatment options are discussed by considering the related literature. The aim is to protect both the visual acuity and the life expectancy of the patients in glaucoma cases caused by intraocular tumor with correct diagnosis and treatment.

Keywords: Oncology; neovascularization; glaucoma
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