埋藏性视乳头玻璃膜疣临床误诊分析

目的:分析误诊为其他疾病的埋藏性视乳头玻璃膜疣的原因和临床特点。方法:回顾性分析8例(10眼)误诊为视乳头水肿和缺血性视神经病变的埋藏性视乳头玻璃膜疣患者的一般情况及视力、眼底、视野、视觉诱发电位、眼底荧光血管造影、眼部B超和头颅CT检查情况等资料。结果:就诊时的视力:0.1-1.0。眼底检查显示所有病例均表现视乳头水肿,边界不清,部分病例可有视乳头或其边缘出血。8例患者中,6例视野正常,2例表现为生理盲点扩大及与视乳头相连的弓形暗点;眼底荧光血管造影均显示视盘部分荧光逐渐增强,后期呈斑块状、结节样或不均匀强荧光,持续时间长,其形态、大小无变化,无荧光素渗漏。视觉诱发电位未见明显异常。B超检查可见视乳头隆起,有结节样强回声。结论:埋藏性视乳头玻璃膜疣临床上较少见,常被误诊为视乳头水肿和缺血性视神经病变,眼底荧光血管造影及眼部B超检查具有诊断意义。

Misdiagnosis of Buried Optic Disc Drusen

Objective: To investigate the reasons of misdiagnosed buried optic disc drusen.Methods: Eight cases(ten eyes) of buried optic disc drusen who had been misdiagnosed were retrospectively studied in vision,fundus appearance,visual field,visual evoked potential(VEP),fundus fluorescein angiography(FFA),B-scan ultrasonography,and computed tomography(CT) scan.Results: Initial vision ranged from 0.1 to 1.0.Fundus examination showed optic nerve edema with blurred disc margins,and some cases even appeared hemorrhage under ophthalmoscopy.Two of the ten eyes had a visual field defect.On FFA,drusen showed irregular hyperfluorescence during the later phase of the angiogram.The disc margins will remain discrete without leakage into the adjacent retina.VEP were normal in all cases.Optic disc bulge and strong echoes were detected by ultrasound.Conclusion: Buried optic disc drusen usually be misdiagnosed as optic nerve edema or ischemic optic neuropathy.The appearance of FFA and ultrasound is important for diagnosing buried optic disc drusen.