被神经眼科诊所称为光学神经病变的黄斑病变:一个病例系列
Amir R Vosoughi1, Laura Donaldson, Jonathan A Micieli
1Max Rady College of Medicine (ARV), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Division of Ophthalmology (LD), Department of Surgery, McMaster University, Hamilton, Canada; Department of Ophthalmology and Vision Sciences (JAM, EAM), Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada; and Division of Neurology (JAM, EAM), Department of Medicine, University of Toronto, Toronto, Canada.
概括
从视神经病变区分黄斑病变至关重要. 斑点光学连贯断层扫描 (OCT) 是区分这些疾病的关键测试,特别是当视网膜神经纤维层 (RNFL) 厚度正常时.
科学领域:
- 眼科医生 眼科 眼科
- 神经眼科神经眼科
- 医学诊断 医学诊断 医学诊断
背景情况:
- 斑点病变和视神经病变有共同的症状,如视敏度下降和色彩视力丧失.
- 将黄斑病症误诊为视神经病变会导致患者受到伤害.
- 准确的区分对于适当的患者管理至关重要.
研究的目的:
- 确定最有帮助的发现和测试,以区分视神经病变与黄斑病变.
- 分析最初怀疑视神经病变但被诊断为黄斑病变的患者的诊断模式.
主要方法:
- 在4.5年内对47名患者进行了回顾性图表审查,这些患者被转介到神经眼科.
- 纳入标准:初步诊断视神经病变,最终诊断黄斑病变.
- 收集的数据:人口统计,临床表现,眼科检查,辅助测试和最终诊断.
主要成果:
- 斑点光学连贯性断层扫描 (OCT) 在84.4%的患者中显示异常.
- 在82.6%的患者中观察到正常的视网膜神经纤维层 (RNFL) 厚度.
- 超过50%的病例中存在良性或病态的磁盘异常.
结论:
- 斑点OCT是一种高产率的测试,用于区分斑点病变和视神经病变.
- 在疑似视神经病变中获得正常RNFL厚度的斑点OCT.
- 斑点缩和斑点退化是视神经病变的常见模仿者.
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