Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, China.
Eur J Med Res. 2011 Jul 25;16(7):324-7. doi: 10.1186/2047-783x-16-7-324.
To recognize ocular presentations in cranial venous sinus thrombosis (CVST) which were easy to be misdiagnosis.
Retrospective study.
Review clinical informations including general informations, general performances, and ocular presentations of 118 inpatients with CVST in the general hospital of chinese people's liberation army during 2005-2009.
The ocular symptoms as the initial onset presentations or simultaneous phenomenon among different onset type patients were analyzed.
Of all the CVST patients, 21.2% (25/118) presented with ocular symptom as the initial presentation, 30.5% (36/118) presented with ocular symptom as well as the other symptoms, and 48.3% (57/118) presented with non-ocular symptoms as the initial onset. The CVST patients were divided into 3 groups according to the onset type. There was no marked statistical significance among groups. The most common major complaints were blurring and degeneration of acute vision, accounting for 85.9% (61/71) of all abnormal ocular chief complaints. The most common objective sign in eyes was papilloedema, accounting for 48.3% (57/118) in this group of CVST patients. About 22.4% (13/58) showed acute vision deterioration at 1-year follow-up, due to optic atrophy.
As ophthalmologists, we should master the onset characteristics and clinical manifestations of CVST. Early diagnosis and treatment is very important for the prevention of vision deterioration, especially for patients with ocular syndrome as the initial onset syndrome. For isolated agnogenic intracranial hypertension, we should consider the possibility of CVST.
为了识别颅静脉窦血栓形成(CVST)中容易误诊的眼部表现。
回顾性研究。
回顾解放军总医院 2005 年至 2009 年间 118 例住院 CVST 患者的一般资料、一般表现和眼部表现的临床资料。
分析不同起病类型患者的眼部症状作为首发表现或同时出现的情况。
所有 CVST 患者中,21.2%(25/118)以眼部症状为首发表现,30.5%(36/118)同时出现眼部症状和其他症状,48.3%(57/118)以非眼部症状为首发表现。根据起病类型将 CVST 患者分为 3 组,组间无显著统计学差异。最常见的主要主诉是视力模糊和减退,占所有异常眼部主要主诉的 85.9%(61/71)。最常见的眼部客观体征是视乳头水肿,占本组 CVST 患者的 48.3%(57/118)。约 22.4%(13/58)在 1 年随访时因视神经萎缩出现急性视力恶化。
作为眼科医生,我们应该掌握 CVST 的发病特点和临床表现。早期诊断和治疗对预防视力恶化非常重要,特别是对于以眼部症状为首发症状的患者。对于孤立性无原因颅内高压,应考虑 CVST 的可能性。