垂体腺瘤的中心视野与误诊分析

Analyses of Central Visual Fields of Pituitary Adenoma

目的:分析垂体腺瘤患者双眼的中心视野及其后极部的眼底改变.方法:应用 Humphrey instructments750型电脑视籽分析仪和 Topcon TRC-50x眼底照相机,对术前70例垂体腺瘤患者行全阈值静态中心视野及眼底检查.结果:视力损害者占64.3％,视野损害者占80.7％;眼底改变者占46.4％.而以视力减退为首诊症状者占45.7％,其中28.6％曾被误诊为眼科疾病.误诊因素主要是患者以视力减退为首诊症状,且多无视野缺损主诉及同时伴有眼科疾病.结论:在眼科临床诊断过程中,对于原因不明的视力下降和解释不清的视神经萎缩,均应把视野作为常规检查,避免漏诊、误诊.

Purpose: To analyze the pituitary adenoma patients' central visual fields of both eyes and their fundus pathological changes. Methods: 70 cases of pituitary adenoma took the static central visual fields of all-liminal values by the Humphrey instruments 750 cycloscope and the fundus examed by the Topcon TRC-50X fundus photography before operations. Results: There were 64.3% of patients' visual acuities decreased, 80.7% with the defects of field vision and 46.4% with fundus pathological changes. The decrease of the visual acuity was the first diagnostic symptom in 45.7% patients, among which 28.6% were misdiagnosed as eye diseases. Conclusions: The misdiagnosed cause is the first diagnostic symptom being only the decrease of visual acuity but with no the defect of field vision. To avoid the misdiagnose and the omitted of the pituitary adenoma, the examination of visual field should be regular in the cases of the decrease of visual acuity and the optic atrophy of unknown reason in the ophthalmologic clinical work.