35例视路病变的视野改变与临床分析

Clinical Analysis of The Change of Perimetry of 35 Cases with Visual Pathway Diseases

目的探讨视路病变的眼科表现,从眼科角度提高对视路病变的早期认识。方法分析首诊于眼科经CT或MRI确诊的35例视路病变的部位以及临床表现、视野检查结果。结果视交叉前病变1例(2.86%),视交叉病变8例(22.86%),视交叉后枕叶前病变8例(22.86%),枕叶病变18例(51.43%)。主诉视物模糊者34例(97.14%),有偏盲症状者6例(17.14%)。视野检查有偏盲者34例(97.14%)。8例视交叉疾病中4例6眼有视神经萎缩。结论有视物模糊主诉或视乳头萎缩而无眼科病变可解释者,应把视野检查作为常规,必要时行CT/MRI检查。

Objective To discuss the ophthalmological performance ot visual pathway diseases, and enhance the early awareness ot visual pathway diseases from the perspective of ophthalmology. Methods We analyzed the diseases sites, clinical manifestation and the results of perimetry of 35 cases with visual pathway diseases which had been definitely diagnosed by CT or MRI with their first outpatient services at Ophthalmology. Results There were 1 patient （2.86%） experiencing pathological change at the area in front of chiasma, 8 patients （22.86%） at optic chiasma, 8 patients （22.86%） at the area behind chiasma and in front of occipital lobe, 18 patients （51.43%） at occipital lobe area. Thirty -four patients （97. 14% ） said their major symptom were blurred vision and 6 patients （17.14%） claimed themselves experiencing hemianopia. Thirty -four patients＇（97.14% ） symptom were hemianopia. Among the 8 pa- tients who had optic chiasma, there were 4 patients with 6 eyes had optic atrophy. Conclusion For those patients who said their major symptom was blurred vision or those patients experiencing discus opticus atrophy which cannot be explained by ophthalmological diseases, it should be regular to do the examination of perimetry and further CT/MRI examination should be made when it is necessary.