颅内病变22例的眼部表现分析

目的:分析颅内病变在眼部表现及诊断方法.方法:回顾性分析22例以眼部症状为主要表现首诊于眼科的颅内病变.结果:视力下降占72.7%,视野改变占63.6%,视神经萎缩占22.7%,视盘水肿占49.9%,瞳孔改变占18.1%,眼肌麻痹占22.7%.初诊时误诊率45.5%.头颅CT或MRI有助于早期诊断,但很难发现较小的病变,视野检查可提供有价值的诊断依据.结论:颅内病变可以通过影响视路、瞳孔反射和眼球运动神经而表现各种眼部症状.对眼部情况难以解释的视力减退或视力疲劳和眼肌麻痹的患者,即使无明显眼底改变也应做视野检查,必要时做头颅CT、MRI或脑血管造影检查,同时要密切随访.

ANALYSIS OF 22 PATIENTS WITH INTRACRANIAL LESIONS PRIMARILY DIAGNOSED BY OPHTHALMOLOGIC EXAMINTION

Objective: To analyse the ocular manifsfations in patients with intracranial lesion and diagnostic methods. Methods: Retrospectively analyse 22 patients came to the ophthalmology department first,after ophthalmologic examination and accessory examination and they were diagnosed as intracrainal lesions. Results: The rates of visual disturbance(72.7%),visual field defect(63.6%), mydriasis(18.1%), and diplopia(22.7%).There is mixdiagnosis rate (45.5%)at first. CT or MRI is helpful to the early diagnosis, but it is difficut to find small lesions.Conclusions:Visual pathway,oculopuillary reflex pathway and oculomotor nerves might be affecred by pressure to develop ocular manifestatious.CT or MRI is valuale and helpful to the early diagnosis ,and visual field examinations may be helpful to the diagnosis of small intracranial lesion for those unconfirmed visual disturbance or fatigne and diplopia cases.