以视力损伤为首发症状克雅氏病1例报告

One Case Report of Creutzfeldt-Jakob Disease with Visual Impairment as the First Symptom

目的：分析以眼科症状为首发表现的克雅氏病的临床特征及鉴别诊断。方法：回顾性分析武汉大学人民医院眼科中心收治的1例克雅氏病患者的临床资料,并结合目前相关研究进展进行文献复习。结果：75岁女性患者,因双眼视力进行性下降50余天入院,黄斑OCT检查提示右眼黄斑前膜,给予黄斑前膜剥除手术治疗,住院期间患者视力继续下降,并伴有情感淡漠,全身运动能力下降,后通过MRI、脑电图及症状体征诊断为散发型克雅氏病。结论：对于有双眼进行性视功能障碍的患者,需考虑到多种可能导致视皮质损伤的神经系统疾病。

Objective：To analyze the clinical characteristics and differential diagnosis of Creutzfeldt-Jakob disease with ocular symptoms as the first manifestation.Methods：The clinical data of one patient with Creutzfeldt-Jakob disease admitted to the eye center of Renmin Hospital of Wuhan University were retrospectively analyzed,and the literature review was carried out according to the current research progress.Results：A 75-year-old female patient was hospitalized due to progressive decline of vision in both eyes more than 50 days,macular OCT examination prompted the anterior macular membrane in the right eye.After removing of the macular membrane,vision continued to decline accompanied by apathy and decreased motor ability.Finally,Creutzfeldt-Jakob disease was diagnosed based on the result of MRI,EEG and clinical manifestations.Conclusion：For patients with biocular progressive visual impairment,a variety of neurological disorders that may cause visual centre injury should be considered.