Lueck Christian J
Department of Neurology, The Canberra Hospital, Canberra, Woden, ACT 2606, Australia.
Pract Neurol. 2010 Dec;10(6):315-25. doi: 10.1136/jnnp.2010.223677.
Visual loss is not uncommon and many patients end up seeing neurologists because of it. There is a long list of possible causes but in most patients visual loss is associated with visual field loss. This means that for practical purposes the differential diagnosis can usually be narrowed down to a manageable shortlist by consideration of where in the visual pathway the lesion is likely to be, along with the time course of the visual loss. This article provides a practical approach to the diagnosis and appropriate investigation of such patients, dividing them into four groups: those in whom vision is lost transiently, acutely, subacutely (i.e., days to weeks) and over a longer time frame (months to years). In addition, there is a discussion of those patients in whom visual loss is not obviously accompanied by any visual field loss.
视力丧失并不罕见，许多患者最终因视力丧失而去看神经科医生。可能的病因有很多，但大多数患者的视力丧失与视野缺损有关。这意味着，实际上，通过考虑病变可能位于视觉通路的哪个部位以及视力丧失的时间进程，鉴别诊断通常可以缩小到一个可管理的短名单。本文提供了一种针对此类患者进行诊断和适当检查的实用方法，将他们分为四组：视力短暂丧失、急性丧失、亚急性丧失（即数天至数周）以及在较长时间范围内（数月至数年）丧失的患者。此外，还讨论了那些视力丧失但无明显视野缺损的患者。
