Purvin V, Kawasaki A, Zeldes S
Midwest Eye Institute and Indiana University Medical Center, Department of Ophthalmology, Indianapolis, Indiana 46280, USA.
J Neurol Neurosurg Psychiatry. 2004 Jan;75(1):27-32.
To characterise the clinical findings and natural history of anterior visual pathway compression by dolichoectatic intracranial vessels.
A retrospective case review of patients evaluated in an outpatient neuro-ophthalmology clinic.
10 patients with this condition were identified. Dolichoectatic compression was confirmed by magnetic resonance scanning in all patients. The average age at presentation was 70.6 years and eight of the 10 were female. The carotid artery was involved in seven patients and the basilar in three. Patterns of visual loss varied depending on the site of compression. The most common pattern in patients with optic neuropathy was nasal field loss. In most patients visual loss showed little progression over time. Over an average follow up interval of 2.8 years, progressive visual loss was documented in only three cases. In one of these, neurosurgical intervention was undertaken with subsequent improvement of vision.
Visual loss resulting from compression of the visual pathways by dolichoectatic arteries is usually mild and only slowly progressive. Most patients are elderly, with other forms of vascular disease. Conservative management is thus usually appropriate in this disorder. In occasional cases with more rapid progression, surgical intervention may be beneficial.
描述颅内迂曲扩张血管对视觉通路前部压迫的临床特征及自然病程。
对在门诊神经眼科诊所接受评估的患者进行回顾性病例分析。
确定了10例患有此病的患者。所有患者均通过磁共振扫描确诊为迂曲扩张压迫。就诊时的平均年龄为70.6岁，10例中有8例为女性。7例患者的颈动脉受累，3例患者的基底动脉受累。视力丧失模式因压迫部位而异。视神经病变患者最常见的模式是鼻侧视野缺损。大多数患者的视力丧失随时间进展缓慢。在平均2.8年的随访间隔中，仅3例记录到视力进行性丧失。其中1例接受了神经外科干预，随后视力有所改善。
迂曲扩张动脉对视觉通路的压迫导致的视力丧失通常较轻且进展缓慢。大多数患者为老年人，伴有其他形式的血管疾病。因此，对于这种疾病，保守治疗通常是合适的。在偶尔进展较快的病例中，手术干预可能有益。
