儿童及青少年神经眼科住院患者病因分析

An etiological analysis of Chinese neuro-ophthalmology disorders in child and adolescent inpatients

目的了解儿童及青少年神经眼科住院患者的病因及病变定位。方法对2009年10月至2011年7月期间，在解放军总医院神经眼科病房住院的儿童及青少年神经眼科患者（〈18岁）的病历资料进行回顾性分析，分类统计病因及病变定位。结果神经眼科住院儿童及青少年患者共129例，视觉传入系统受累共120例（包括视觉传入传出系统同时受累共4例），其中视神经疾病93例，占视觉传入系统受累患者的77．50％，占全部住院患者的72．09％；眼部运动传卅系统受累13例（包括视觉传入传出系统同时受累共4例）。其中眼球运动障碍为主，共9例，占传出系统受累患者的69．23％，占全部住院患者的6．98％。单眼发病53例，双眼发病76例，共累及205只眼。病因明确者118例，占总病例数91．47％。结论在儿童及青少年神经眼科住院患者中，视神经是最常见的受累部位。其中原发性脱髓鞘性疾病、外伤性视神经病变及遗传或先天性视神经病变是视神经疾病最常见的原因。

Objective To investigate the etiology of pediatric neuro-ophthalmology disorders in China. Methods Retrospective case series. Clinical data of children and adolescents 〈18 years suf-fered from neuro-ophthalmology diseases who hospitalized in the Department of Neuro-ophthalmolo-gy, General Hospital of PLA from October 2009 to July 2011 was reviewed. Results Totally 129 patients were recruited to study. The visual afferent system of 120 cases was injured including 93 cases with optic neuropathy, which accounted for 77.50% of the patients with visual afferent system injured and 72.09% of the total hospitalized patients. The efferent nerve system of 13 cases was in-jured. The ocular motor system was affected in 9 cases, which accounted for 69.23% of the patients with efferent nerve system affected and 6.98% of the total hospitalized patients. Unilateral eye was affected in 53 cases, and bilateral eyes were affected in 76 cases, involving a total of 205 eyes, 118 cases （91.47%） were identified the original reasons. There were optic neuritis （33 cases）, traumat-ic neuropathy （30 cases）, congenital or hereditary optic neuropathy （18 cases）, brain tumor or intra-cranial compressive disorder （14 cases）, infectious disease （8 cases）, vascular diseases （5 cases）, my-asthemia gravis （3 cases）, psychogenic hypopsia （2 cases）, idiopathic intracranial hypertension （2 cas-es）, inflammatory disease （2 cases）, Adie＇s syndrome （1 case）, and idiopathic oculomotor nerve pal-sy （1 case）. Conclusions Optic neuropathy is the most common disorder in neuro-ophthalmology in child and adolescent inpatients. Optic neuritis, traumatic optic neuropathy and congenital or heredi-tary optic neuropathy are major causes for optic neuropathy.