与儿童维生素A缺乏相关的视神经病变:一个案例系列
Christine Bourke1, Vasiliki Panteli1, Oliver R Marmoy1
1Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital, London, United Kingdom.
概括
自闭症谱系障碍 (ASD) 的儿童的避免/限制性食物摄入障碍 (ARFID) 可以导致严重的维生素A缺乏症 (VAD). 这可能会导致视通道高静止和不可逆转的视力丧失,突出显示了早期营养干预的必要性.
科学领域:
- 眼科医生 眼科 眼科
- 营养科学 营养科学
- 儿科神经学 儿科神经学
背景情况:
- 维生素A缺乏 (VAD) 在高收入国家越来越令人担忧,与胃肠道问题,限制性饮食和避免/限制性食物摄入障碍 (ARFID) 有关.
- 经常在患有自闭症谱系障碍 (ASD) 的人群中观察到的ARFID,可以导致严重的营养缺陷,具有显著的系统和眼睛影响.
- 这项研究侧重于ASD和ARFID的儿科病例,这些病例因视通道超静止和VAD的二次压缩性视神经病变而经历了严重的视力损失.
研究的目的:
- 调查ARFID,VAD和视神经病变在患有ASD的儿科患者之间的联系.
- 描述这些患者的临床,成像和电生理学发现.
- 强调早期诊断和营养不足的管理的重要性,以防止视力丧失.
主要方法:
- 在2024年1月至2024年12月期间,对被诊断患有VAD,视神经病变和视通道超静止症的儿科患者的医疗记录进行了回顾性审查.
- 包括眼科评估,电诊断测试, fundus成像,血清学测试和神经放射学调查在内的全面数据收集.
- 对饮食模式的分析,重点关注与ARFID相关的限制性饮食行为.
主要成果:
- 五名患有ASD和ARFID的儿科患者呈现出视力障碍,视力缩和高度限制的营养缺乏饮食.
- 调查证实了VAD和其他营养缺陷,成像显示头骨变厚,视通道变窄和视神经压缩.
- 在大多数情况下,维生素A补充并没有改善视力,这表明视神经受到了不可逆转的损伤;在一个案例中,手术减压没有恢复视力.
结论:
- 早期识别和管理与ARFID相关的营养不足对于预防视力损失等不可逆转的眼科并发症至关重要.
- 这些发现突出了由于VAD诱导的视通道超静止症导致的严重视力损伤的可能性,在患有ASD和ARFID的儿童中.
- 需要进一步的研究来确定最佳的管理策略,包括视通道减压的潜在作用.
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