Volpe N J, Rizzo J F, Lessell S
Department of Ophthalmology, School of Medicine, University of Pennsylvania, Philadelphia, USA.
Arch Ophthalmol. 2001 Jan;119(1):59-63.
To describe the clinical findings in patients with acute idiopathic blind spot enlargement (AIBSE).
Medical record review of 27 patients with AIBSE (without sufficient optic nerve head swelling to cause blind spot enlargement) seen in 2 academic neuro-ophthalmology units.
All patients were women aged between 19 and 53 years. Twenty-three patients reported positive visual phenomena. Visual acuity was normal in 16 patients. All patients had enlarged blind spots of variable size and density. Dyschromatopsia and afferent pupil defects were prevalent. Ophthalmoscopic features included uveitis, mild optic nerve swelling, granularity of macular pigment, subretinal white dots, and peripapillary pigment disturbances. Twelve of the 13 patients who underwent fluorescein angiography had optic disc staining and 5 had retinal pigment epithelial lesions with late staining. Full-field electroretinogram results were normal in 8 of 9 patients, although focal electroretinogram results were abnormal in 8 of 9 patients. Photopsia always decreased but visual fields did not improve. Six patients experienced recurrence.
The clinical features of AIBSE include photopsia, visual field defects, abnormal findings from fundoscopic and fluorescein angiography, and abnormal results of focal electroretinography. The disease affects the peripapillary retina and may cause an afferent pupillary defect. The striking predilection for the peripapillary retina suggests a local etiologic factor and distinguishes AIBSE from the multiple evanescent white dot syndrome. Unlike patients with multiple evanescent white dot syndrome, recovery of visual field did not occur in patients with AIBSE.
描述急性特发性盲点扩大（AIBSE）患者的临床特征。
回顾了在两个学术性神经眼科单位就诊的27例AIBSE患者（视神经乳头肿胀程度不足以导致盲点扩大）的病历。
所有患者均为女性，年龄在19至53岁之间。23例患者报告有阳性视觉现象。16例患者视力正常。所有患者的盲点均扩大，大小和密度各异。色觉异常和传入性瞳孔缺陷很常见。眼底镜检查特征包括葡萄膜炎、轻度视神经肿胀、黄斑色素颗粒状、视网膜下白点和视乳头周围色素紊乱。13例行荧光素血管造影的患者中，12例有视盘染色，5例有视网膜色素上皮病变及晚期染色。9例患者中8例的全视野视网膜电图结果正常，尽管9例患者中有8例的局部视网膜电图结果异常。闪光幻觉总是减轻，但视野并未改善。6例患者复发。
AIBSE的临床特征包括闪光幻觉、视野缺损、眼底镜和荧光素血管造影异常发现以及局部视网膜电图结果异常。该病影响视乳头周围视网膜，可能导致传入性瞳孔缺陷。对视乳头周围视网膜的显著偏好提示存在局部病因，这将AIBSE与多发性一过性白点综合征区分开来。与多发性一过性白点综合征患者不同，AIBSE患者的视野并未恢复。
