良性颅内压增高症的眼部表现  

Ocular manifestation of benign intracranial hypertension

作　　者：王伟伟[1] 杨新光[1] 

机构地区：[1]中国陕西省西安市第四医院眼科,710004

出　　处：《国际眼科杂志》2013年第8期1732-1734,共3页International Eye Science

摘　　要：目的: 探讨良性颅内压增高症的眼部特点。方法: 回顾性分析在西安市第四医院神经内科确诊且经眼科会诊的良性颅内压增高症患者21例42眼的临床资料,包括患者视力、裂隙灯显微镜、散瞳后眼底、荧光素眼底血管造影及全脑血管造影、头部影像学检查等资料。结果: 患者21例中,14例(67%)因眼部症状首诊于眼科。初诊视力:无光感者1眼(2%),手动/眼前～0.1者5眼(12%),0.2～1.0者16眼(38%),1.0以上者20眼(48%)。眼前节检查可见1眼(2%)因外展神经麻痹而出现外斜视。散瞳眼底检查,10例(48%)患者可见双眼视乳头水肿,1例患者(5%)单眼视乳头水肿,2例(10%)患者(3眼)出现视神经萎缩,余8例(38%)患者眼底无异常。结论: 良性颅内压增高症的眼部表现主要为视力下降和视乳头水肿,晚期可出现视神经萎缩。患者可因眼部症状首诊于眼科。眼科医师认识良性颅内压增高症的眼部表现特点,及时给予正确的诊断与治疗,可挽救患者的视功能。·AIM： To evaluate the ocular manifestation of benign intracranial hypertension （BIH）. ·ETHODS ： Retrospective case series was taken to study the clinical data of 21 patients （42 eyes） diagnosed with BIH at Xi＇an No. 4 Hospital from February 2002 to October 2011. Examinations included visual acuity, slit- lamp, fundus, fundus fluorescein angiography （FFA）, cerebral angiography and brain imaging tests. ·RESULTS： Of 21 cases, there were 14 patients （67%） recognized by initial presentation of impaired vision prior to the diagnosis of BIH. Visual acuity： no light perception 1 eye （2%）, hand motion to 0.1 in 5 eyes （12%）, 0.2-1.0 in 16 eyes （38%）, and 20 eyes （48%） above 1.0. The ocular examination revealed exotropia in 1 eye （2%） resulted from abducentparalysis. The fundus examination showed binocular papilledema in 10 cases （48%）, monocular papiiledema in one case （5%）, optic atrophy in 3 eyes of 2 cases （10%）, and nothing wrong in 8 cases （38%）. ·CONCLUSION： Ocular manifestation of BIH is usually characterized by impaired vision and papilledema, and optic atrophy occurs at advanced stage. Some patients present with impaired vision at first. The prognosis could be improved if ophthalmologists know ocular characteristics of BIH and give timely and correct diagnosis and treatment.

关 键 词：颅内压增高 视乳头水肿 视敏度 

分 类 号：R771.3[医药卫生—眼科]