Cochard-Marianowski C, Lamirel C, Biousse V
Service d'ophtalmologie, CHU Morvan, 5 avenue Foch, Brest, France.
J Fr Ophtalmol. 2009 Dec;32(10):765-9. doi: 10.1016/j.jfo.2009.10.009.
Diagnosis and management of transient monocular visual loss is an emergency. Ocular conditions causing transient visual loss are routinely managed by ophthalmologists. Vascular transient monocular visual loss may result from emboli, hypoperfusion, vasospasm, or venous congestion. Evaluation focuses on the carotid arteries, ophthalmic arteries, the aortic arch, the heart, and rarely hypercoagulable states. Secondary prevention of ischemic events is essential in order to prevent permanent visual loss as well as cerebral ischemic and cardiovascular death. Aggressive treatment of vascular risk factors is usually associated with antiplatelet agents. Anticoagulant and carotid surgery are only rarely required after vascular transient monocular visual loss.
短暂性单眼视力丧失的诊断与处理是一项紧急情况。导致短暂性视力丧失的眼部疾病通常由眼科医生进行处理。血管性短暂性单眼视力丧失可能由栓子、低灌注、血管痉挛或静脉充血引起。评估重点在于颈动脉、眼动脉、主动脉弓、心脏,以及罕见的高凝状态。为预防永久性视力丧失以及脑缺血和心血管死亡,缺血事件的二级预防至关重要。积极治疗血管危险因素通常联合使用抗血小板药物。血管性短暂性单眼视力丧失后很少需要抗凝治疗和颈动脉手术。