眼部毒性眼部毒性.pdf

表8眼毒性评分（Ocular Toxicity Scoring）
表8 眼毒性评分

Toxicity 毒性	Grade 1 1 级	Grade 2 二年级	Grade 3 三年级	Grade 4 四年级
Keratitis （corneal inflammation／ corneal ulceration）角膜炎（角膜炎症/角膜溃疡）	Abnormal ophthalmologic changes only； intervention not indicated 仅眼科异常变化;无干预指示	Symptomatic； medical intervention indicated 有症状;需要医疗干预	Symptomatic； surgical intervention indicated 有症状;需要手术干预	Perforation or blindness（worse than baseline visual function）穿孔或失明（比基线视觉功能差）
Anterior Segment Inflammation 眼前节炎症	Cell and flare that resolves within 6 weeks with topical treatment 局部治疗后 6 周内消退的细胞和耀斑	Fibrinous reaction that resolves within 6 weeks with local treatment 局部治疗在 6 周内消退的纤维蛋白反应	Iridocyclitis that persists between 6 weeks and 6 months，controlled with local／systemic treatment 虹膜睫状体炎持续 6 周至 6 个月，通过局部/全身治疗控制	Persistent（ $> 6 mos$ ） iridocyclitis requiring chronic systemic anti－ inflammatory therapy and／or surgery 需要慢性全身抗炎治疗和/或手术的持续性虹 $> 6 mos$ 膜睫状体炎
Posterior Segment Inflammation 后段炎症	Mild vitritis（cells） that resolves without treatment 无需治疗即可消退的轻度玻璃体炎（细胞）	Vitritis that resolves only with topical treatment 只有局部治疗才能消退的玻璃体炎	Vitritis impairing view of fundus， require local treatment 玻璃体炎损害眼底视力，需要局部治疗	Vitritis with poor view of fundus details，requires chronic systemic treatment and／or surgery 眼底细节看不清的玻璃体炎，需要长期全身治疗和/或手术
Intraocular Pressure（IOP）眼压（IOP）	Mild increase in IOP（ $> 25 mm Hg$ ）， persisting for $> 72$ hours 眼压（）轻度升高 $> 25 mm Hg$ ，持续 $> 72$ 数小时	Moderate increase in IOP （ $> 30 mm Hg$ ）， lasting more than 14 days， responds to topical therapy 眼压中度升高（ $> 30 mm Hg$ ），持续超过 14 天，对局部治疗有反应	Sustained Elevation in IOP （ $> 30 mm Hg$ ），for more than 30 days， requiring more than one medication 眼压持续升高（ $> 30 mm Hg$ ），超过 30 天，需要一种以上药物	Sustained Elevation in IOP（ $> 30 mm$ Hg ），for more than 30 days，with loss of vision or requiring multiple incisional surgeries 眼压（ $> 30 mm$ Hg）持续升高，持续超过 30 天，视力丧失或需要多次切口手术
Retinal Inflammation 视网膜炎症	Focal dot hemorrhages 局灶性点出血	Multiple intraretinal hemorrhages and areas of vasculitis 多发性视网膜内出血和血管炎区域	Focal areas of retinal whitening with vascular occlusion 血管闭塞的视网膜美白的焦点区域	Confluent areas of retinal necrosis with vascular occlusion causing permanent vision loss 视网膜坏死的汇合区域与血管闭塞导致永久性视力丧失
Retinal surgical changes 视网膜手术变化	Visible subretinal fluid or blood＞2－ disc areas beyond the retinotomy site 视网膜切开部位以外的可见视网膜下液或血>2-椎间盘区域	Subretinal fluid， or blood beyond bleb site， localized retinal detachment 视网膜下积液，或水泡部位以外的血液，局部视网膜脱离	Choroidal effusion in 4 quadrants， recurrent retinal detachment 4 个象限脉络膜积液，复发性视网膜脱离	Proliferative vitreoretinopathy， Phthisis bulbi 增殖性玻璃体视网膜病变，球状疱疹
Retinal detachment 视网膜脱离	Localized and intervention not indicated 局部化和未指征干预	Not resolving but intervention not yet indicated 未解决但尚未指示干预	Operative intervention indicated 需要手术干预	Operative failure threatening ocular integrity 威胁眼部完整性的手术失败
Optic Nerve Toxicity 视神经毒性	Mild segmental swelling 轻度节段性肿胀	Moderate segmental swelling 中度节段肿胀	Generalized optic disc edema not related to hypotony or uveitis 与低血压或葡萄膜炎无关的全身性视盘水肿	Atrophy／advanced cupping or optic neuritis causing loss of vision 萎缩/晚期拔罐或视神经炎导致视力丧失

Toxicity Grade 1 Grade 2 Grade 3 Grade 4 Keratitis （corneal inflammation／ corneal ulceration） Abnormal ophthalmologic changes only； intervention not indicated Symptomatic； medical intervention indicated Symptomatic； surgical intervention indicated Perforation or blindness（worse than baseline visual function） Anterior Segment Inflammation Cell and flare that resolves within 6 weeks with topical treatment Fibrinous reaction that resolves within 6 weeks with local treatment Iridocyclitis that persists between 6 weeks and 6 months，controlled with local／systemic treatment Persistent（ > 6mos ） iridocyclitis requiring chronic systemic anti－ inflammatory therapy and／or surgery Posterior Segment Inflammation Mild vitritis（cells） that resolves without treatment Vitritis that resolves only with topical treatment Vitritis impairing view of fundus， require local treatment Vitritis with poor view of fundus details，requires chronic systemic treatment and／or surgery Intraocular Pressure（IOP） Mild increase in IOP（ > 25mmHg ）， persisting for > 72 hours Moderate increase in IOP （ > 30mmHg ）， lasting more than 14 days， responds to topical therapy Sustained Elevation in IOP （ > 30mmHg ），for more than 30 days， requiring more than one medication Sustained Elevation in IOP（ > 30mm Hg ），for more than 30 days，with loss of vision or requiring multiple incisional surgeries Retinal Inflammation Focal dot hemorrhages Multiple intraretinal hemorrhages and areas of vasculitis Focal areas of retinal whitening with vascular occlusion Confluent areas of retinal necrosis with vascular occlusion causing permanent vision loss Retinal surgical changes Visible subretinal fluid or blood＞2－ disc areas beyond the retinotomy site Subretinal fluid， or blood beyond bleb site， localized retinal detachment Choroidal effusion in 4 quadrants， recurrent retinal detachment Proliferative vitreoretinopathy， Phthisis bulbi Retinal detachment Localized and intervention not indicated Not resolving but intervention not yet indicated Operative intervention indicated Operative failure threatening ocular integrity Optic Nerve Toxicity Mild segmental swelling Moderate segmental swelling Generalized optic disc edema not related to hypotony or uveitis Atrophy／advanced cupping or optic neuritis causing loss of vision

| Toxicity | Grade 1 | Grade 2 | Grade 3 | Grade 4 | | :--- | :--- | :--- | :--- | :--- | | Keratitis （corneal inflammation／ corneal ulceration） | Abnormal ophthalmologic changes only； intervention not indicated | Symptomatic； medical intervention indicated | Symptomatic； surgical intervention indicated | Perforation or blindness（worse than baseline visual function） | | Anterior Segment Inflammation | Cell and flare that resolves within 6 weeks with topical treatment | Fibrinous reaction that resolves within 6 weeks with local treatment | Iridocyclitis that persists between 6 weeks and 6 months，controlled with local／systemic treatment | Persistent（ $>6 \mathrm{mos}$ ） iridocyclitis requiring chronic systemic anti－ inflammatory therapy and／or surgery | | Posterior Segment Inflammation | Mild vitritis（cells） that resolves without treatment | Vitritis that resolves only with topical treatment | Vitritis impairing view of fundus， require local treatment | Vitritis with poor view of fundus details，requires chronic systemic treatment and／or surgery | | Intraocular Pressure（IOP） | Mild increase in IOP（ $>25 \mathrm{~mm} \mathrm{Hg}$ ）， persisting for $>72$ hours | Moderate increase in IOP （ $>30 \mathrm{~mm} \mathrm{Hg}$ ）， lasting more than 14 days， responds to topical therapy | Sustained Elevation in IOP （ $>30 \mathrm{~mm} \mathrm{Hg}$ ），for more than 30 days， requiring more than one medication | Sustained Elevation in IOP（ $>30 \mathrm{~mm}$ Hg ），for more than 30 days，with loss of vision or requiring multiple incisional surgeries | | Retinal Inflammation | Focal dot hemorrhages | Multiple intraretinal hemorrhages and areas of vasculitis | Focal areas of retinal whitening with vascular occlusion | Confluent areas of retinal necrosis with vascular occlusion causing permanent vision loss | | Retinal surgical changes | Visible subretinal fluid or blood＞2－ disc areas beyond the retinotomy site | Subretinal fluid， or blood beyond bleb site， localized retinal detachment | Choroidal effusion in 4 quadrants， recurrent retinal detachment | Proliferative vitreoretinopathy， Phthisis bulbi | | Retinal detachment | Localized and intervention not indicated | Not resolving but intervention not yet indicated | Operative intervention indicated | Operative failure threatening ocular integrity | | Optic Nerve Toxicity | Mild segmental swelling | Moderate segmental swelling | Generalized optic disc edema not related to hypotony or uveitis | Atrophy／advanced cupping or optic neuritis causing loss of vision |

表8眼毒性评分（Ocular Toxicity Scoring）表8 眼毒性评分

表8眼毒性评分（Ocular Toxicity Scoring）
表8 眼毒性评分