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

Toxicity  毒性 Grade 1  一级 Grade 2  二级 Grade 3  3 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
眼部变化异常;无需干预
Symptomatic; medical intervention indicated
症状性;需要医疗干预
Symptomatic; surgical intervention indicated
症状性;建议手术干预
Perforation or blindness(worse than baseline visual function)
穿孔或失明(视力功能比基线更差)
Anterior Segment Inflammation
眼前段炎症
Cell and flare that resolves within 6 weeks with topical treatment
细胞和炎症在 6 周内通过局部治疗消退
Fibrinous reaction that resolves within 6 weeks with local treatment
纤维素性反应,经局部治疗 6 周内可缓解
Iridocyclitis that persists between 6 weeks and 6 months,controlled with local/systemic treatment
虹膜睫状体炎持续 6 周到 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
持续(>6 个月)的虹膜睫状体炎,需要长期系统性抗炎治疗和/或手术

后节段炎症
Posterior
Segment
Inflammation
Posterior Segment Inflammation| Posterior | | :--- | | Segment | | Inflammation |
Mild vitritis(cells) that resolves without treatment
轻度玻璃体炎(细胞),无需治疗即可自愈
Vitritis that resolves only with topical treatment
眼内炎仅通过局部治疗缓解
Vitritis impairing view of fundus, require local treatment
玻璃体混浊影响眼底观察,需局部治疗
Vitritis with poor view of fundus details,requires chronic systemic treatment and/or surgery
玻璃体混浊,眼底细节看不清,需要长期系统性治疗和/或手术

眼内压(IOP)
Intraocular
Pressure(IOP)
Intraocular Pressure(IOP)| Intraocular | | :--- | | Pressure(IOP) |
Mild increase in IOP( > 25 mm Hg > 25 mm Hg > 25mmHg>25 \mathrm{~mm} \mathrm{Hg} ), persisting for > 72 > 72 > 72>72 hours
眼内压(IOP)轻微升高( > 25 mm Hg > 25 mm Hg > 25mmHg>25 \mathrm{~mm} \mathrm{Hg} ),持续 > 72 > 72 > 72>72 小时
Moderate increase in IOP ( > 30 mm Hg > 30 mm Hg > 30mmHg>30 \mathrm{~mm} \mathrm{Hg} ), lasting more than 14 days, responds to topical therapy
眼内压( > 30 mm Hg > 30 mm Hg > 30mmHg>30 \mathrm{~mm} \mathrm{Hg} )中度升高,持续时间超过 14 天,对局部治疗有反应
Sustained Elevation in IOP ( > 30 mm Hg > 30 mm Hg > 30mmHg>30 \mathrm{~mm} \mathrm{Hg} ),for more than 30 days, requiring more than one medication
持续升高眼内压( > 30 mm Hg > 30 mm Hg > 30mmHg>30 \mathrm{~mm} \mathrm{Hg} ),超过 30 天,需要超过一种药物
Sustained Elevation in IOP( > 30 mm > 30 mm > 30mm>30 \mathrm{~mm} Hg ),for more than 30 days,with loss of vision or requiring multiple incisional surgeries
持续的眼内压( > 30 mm > 30 mm > 30mm>30 \mathrm{~mm} Hg)升高超过 30 天,伴有视力丧失或需要多次切口手术
Retinal Inflammation  视网膜炎症 Focal dot hemorrhages  焦点点状出血 Multiple intraretinal hemorrhages and areas of vasculitis
多发性视网膜出血和血管炎区域
Focal areas of retinal whitening with vascular occlusion
视网膜白化区域的焦点,血管阻塞
Confluent areas of retinal necrosis with vascular occlusion causing permanent vision loss
视网膜坏死融合区域,血管阻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
可见的视网膜下液体或血液>2-超出视网膜切开术部位的视盘区域
Subretinal fluid, or blood beyond bleb site, localized retinal detachment
玻璃体下液,或超出黄斑区的血液,局部视网膜脱离
Choroidal effusion in 4 quadrants, recurrent retinal detachment
视网膜脱离,四象限脉络膜渗出
Proliferative vitreoretinopathy, Phthisis bulbi
增殖性玻璃体视网膜病变,眼球萎缩
Retinal detachment  视网膜脱落 Localized and intervention not indicated
局部化和干预不适宜
Not resolving but intervention not yet indicated
无法解决,但尚未表明需要干预
Operative intervention indicated
手术干预指征
Operative failure threatening ocular integrity
手术失败威胁眼完整性
Optic Nerve Toxicity  视神经毒性 Mild segmental swelling  轻微节段性肿胀 Moderate segmental swelling
中度节段性肿胀
Generalized optic disc edema not related to hypotony or uveitis
全身性视神经盘水肿,与低眼压或葡萄膜炎无关
Atrophy/advanced cupping or optic neuritis causing loss of vision
萎缩/晚期杯状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(>6 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( > 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 mos) iridocyclitis requiring chronic systemic anti- inflammatory therapy and/or surgery | | Posterior <br> Segment <br> 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 <br> 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 |