Denis D, Girard N, Levy-Mozziconacci A, Berbis J, Matonti F
Service d'ophtalmologie, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
J Fr Ophtalmol. 2013 Mar;36(3):210-20. doi: 10.1016/j.jfo.2012.02.014. Epub 2012 Nov 21.
Congenital ocular colobomas are the result of a failure in closure of the embryonal fissure. We present a prospective study (2007-2011) in which we report brain MRI findings in children with ocular coloboma.
Thirty-five children (54 eyes) were included; 15 boys, 20 girls with a median age of 24.0 months (1.0-96.0) at first presentation. Within 2 to 3 months following complete ophthalmologic examination, brain MRI was performed.
Colobomas were bilateral in 19 cases and unilateral in 16 cases. Eleven different types of coloboma were identified. Of 54 eyes, 74% demonstrated optic nerve coloboma, of which 28 were severe. Of 35 MRI's performed, abnormalities were present in 86%: gyration abnormalities (n=21), lateral ventricular dilatation (n=17), dilatation of the Virchow-Robin and subarachnoid spaces (n=14), signal abnormalities and brain stem malformations (n=14), white matter signal abnormalities (n=11), corpus callosum abnormalities (n=10). Most of these abnormalities were related. Gyration abnormalities were the most frequent. There was no significant association between the severity of the coloboma and the abnormalities found (P=1.0). Likewise, there was no significant association of gyration abnormalities with the severity of coloboma in children (P=1.0).
This study shows, for the first time, the existence of frequent cerebral abnormalities on MRI in children with ocular coloboma. The most common abnormality being gyration abnormalities, in 60% of cases.
先天性眼裂闭合不全是胚胎裂闭合失败的结果。我们开展了一项前瞻性研究(2007 - 2011年),报告眼裂闭合不全患儿的脑部磁共振成像(MRI)结果。
纳入35名儿童(54只眼);其中15名男孩,20名女孩,首次就诊时的中位年龄为24.0个月(1.0 - 96.0个月)。在完成眼科全面检查后的2至3个月内进行脑部MRI检查。
19例为双侧眼裂闭合不全,16例为单侧。共识别出11种不同类型的眼裂闭合不全。在54只眼中,74%表现为视神经缺损,其中28例为严重缺损。在35次MRI检查中,86%存在异常:脑回异常(n = 21)、侧脑室扩张(n = 17)、Virchow - Robin间隙和蛛网膜下腔扩张(n = 14)、信号异常及脑干畸形(n = 14)、白质信号异常(n = 11)、胼胝体异常(n = 10)。这些异常大多相互关联。脑回异常最为常见。眼裂闭合不全的严重程度与所发现的异常之间无显著关联(P = 1.0)。同样,儿童脑回异常与眼裂闭合不全的严重程度之间也无显著关联(P = 1.0)。
本研究首次表明,眼裂闭合不全患儿的MRI检查中频繁存在脑部异常。最常见的异常是脑回异常,占60%的病例。