隐匿型间接视神经损伤的临床特点分析

Clinical features of occult indirect optic nerve injury

  • 摘要: 目的 探讨隐匿型间接视神经损伤的临床特点。方法 回顾性分析2005年6月-2009年6月间,我科收治的隐匿型间接视神经损伤患者15例(18眼)的临床特点,包括主诉、外伤特点、视力变化、瞳孔及眼底改变、视野、视觉诱发电位、视觉对比敏感度等特点。结果 15例患者首次就诊均因视力下降不明显及眼底检查正常而漏诊。临床特点:伤后早期视力轻度改变,有眼前亮度及色觉异常,出现相对性瞳孔传入性障碍,视觉诱发电位、视野、视觉对比敏感度异常。结论 对眼部外伤特别是眉弓处外伤、伤后视力改变不明显但有亮度及色度觉改变患者,应进一步检查是否存在相对性瞳孔传入性障碍,并作视觉诱发电位、视野、视觉对比敏感度等检查以明确有无视神经的损伤,避免漏诊而延误治疗。

     

    Abstract: Objective To study the clinical features of occult indirect optic nerve injury. Methods Clinical features, including chief complaint, characteristics of trauma, changes in vision, pupil and fudus, and visual field, vision-evoked potential, visual contrast sensitivity, in 15 patients (18 eyes) admitted to our department in June 2005 -June 2009 due to occult indirect optic nerve injury, were retrospectively analyzed. Results The diagnosis of all patients was missed due to their nearly normal vision and ocular fundus at the first visit to our department. The clinical features of occult indirect optic nerve injury included a slight decrease in vision after injury, sense of light and color, relative afferent defect of pupils, and abnormal visual field, vision-evoked potential, visual contrast sensitivity. Conclusion In order to avoid missed diagnosis of occult indirect optic nerve injury, relative afferent defect of pupils, visual field, vision-evoked potential, visual contrast sensitivity should be carefully examined in patients with blunt trauma on eyeballs, especially on the brow, if they have insignificant changes in vision but have change in color and color degree.

     

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