在异常发病性脑内内高血压中缩光学盘的胀
Jim Shenchu Xie1, Laura Donaldson, Edward A Margolin
1Michael G. DeGroote School of Medicine (JSX), McMaster University, Hamilton, Canada; Division of Ophthalmology (LD), Department of Surgery, McMaster University, Hamilton, Canada; Department of Ophthalmology and Vision Sciences (EAM), University of Toronto, Toronto, Canada; and Division of Neurology (EAM), Department of Medicine, University of Toronto, Toronto, Canada.
概括
光学连贯性断层扫描 (OCT) 可以检测在患有异常性内高血压 (IIH) 和视力缩的患者中乳头瘤复发. 建议对这些患者进行长距离监测,用周状视网膜神经纤维层 (pRNFL) 测量.
科学领域:
- 眼科医生 眼科 眼科
- 神经眼科神经眼科
- 医疗成像医学成像
背景情况:
- 在视力缩的患者中,由于在眼镜镜检查中微妙或不存在的乳头瘤,异形内高血压 (IIH) 的监测具有挑战性.
- 光学连贯断层扫描 (OCT) 可能提供一种敏感的方法来检测在这个人群中复发的 papilledema.
研究的目的:
- 评估OCT在检测IIH患者和视力缩患者的乳头炎复发中的实用性.
- 建立识别 papilledema 复发的标准,使用 peripapillary 视网膜神经纤维层 (pRNFL) 厚度测量.
主要方法:
- 对IIH和视力缩患者的回顾性图表审查.
- 连续评估包括眼镜镜检查和周周毛囊的OCT.
- 视力缩的定义基于pRNFL厚度 (≤80微米中度,≤60微米严重).
- 乳头瘤被定义为≥6μm的PRNFL升高,随后降低至基线.
主要成果:
- 在165名IIH患者中,32只眼睛有中度和22只眼睛有严重的视力缩.
- 在平均198.5周的随访期间,63.3%的患者复发了,而50.0%的患者出现了 papilledema 发作.
- 在12名没有临床症状的患者和17名具有临床和OCT证据的患者中,OCT检测到 papilledema.
- 在中度和严重缩的眼睛中,pRNFL的胀率和大小是相似的.
结论:
- 在IIH患者的视光盘缩中,OCT有效检测 papilledema 复发.
- 使用OCT进行纵向PRNFL监测,建议对所有缩IIH的患者进行监测.
- 同时的临床和OCT发现表明复发需要进一步调查.
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