Jiraskova Nada, Kuba Miroslav, Kremlacek Jan, Rozsival Pavel
Department of Ophthalmology, Charles University in Prague, Hradec Kralove, Czech Republic.
Doc Ophthalmol. 2011 Aug;123(1):51-7. doi: 10.1007/s10633-011-9275-0. Epub 2011 Jun 7.
To present a unique case of a 34-year-old patient with unilateral functional visual loss after chemical burn with normal visual evoked potentials (VEPs) and absent cognitive response (P300 wave).
Visual functions, complete ophthalmic and neurologic examinations including computed tomography of the brain, electrophysiological testing of the visual pathway up to the cognitive brain cortex were evaluated. Data were collected prospectively during 1-year follow-up and compared with data from published case series and a literature review.
No abnormalities were found that could account for such a rapid monocular loss of vision with exception of absence of the P300 wave in the affected eye during cognitive tasks. Vision slowly improved during 1 year without any treatment.
Functional vision loss is a diagnosis of exclusion. In the event of reduced vision in the context of a normal ocular health examination, all other pathology must be ruled out before the diagnosis of functional visual loss is established. Complex visual electrophysiological testing is the preferred tool for objective examination of such disorders.
报告一例34岁患者在化学烧伤后出现单侧功能性视力丧失的独特病例，其视觉诱发电位（VEP）正常但认知反应（P300波）缺失。
评估视觉功能、全面的眼科和神经科检查，包括脑部计算机断层扫描，以及直至认知脑皮质的视觉通路电生理测试。在1年随访期间前瞻性收集数据，并与已发表病例系列的数据和文献综述进行比较。
除了在认知任务期间患眼P300波缺失外，未发现可解释如此迅速的单眼视力丧失的异常情况。未经任何治疗，视力在1年内缓慢改善。
功能性视力丧失是一种排除性诊断。在眼部健康检查正常的情况下出现视力下降时，在确立功能性视力丧失的诊断之前，必须排除所有其他病变。复杂的视觉电生理测试是客观检查此类疾病的首选工具。
