Tytla M E, Buncic J R
Department of Ophthalmology, Hospital for Sick Children, Toronto, Ontario, Canada.
Arch Ophthalmol. 1990 May;108(5):701-4. doi: 10.1001/archopht.1990.01070070087041.
Individuals with papilledema due to intracranial hypertension often exhibit a loss of contrast sensitivity confined to low spatial frequency (coarse detail), which can disappear following treatment of the intracranial hypertension. The basis of the initial loss may be revealed by the rate of sensitivity recovery. We monitored the contrast sensitivity of seven patients immediately before and after surgical treatment in which a shunt was placed for intracranial hypertension. Compared with normal controls, the 13 of 14 eyes with papilledema exhibited the characteristic preshunt loss of sensitivity. For the first 3 days after shunt placement, sensitivity remained approximately equal to preshunt levels. By postshunt days 4 through 6, sensitivity rapidly normalized and remained normal for up to 1 year. Based on the rate and pattern of sensitivity normalization, we conclude that the initial loss represents an interaction of axoplasmic stasis with ischemia at the level of the optic nerve.
因颅内高压导致视乳头水肿的个体，常常表现出仅局限于低空间频率（粗略细节）的对比敏感度丧失，这种情况在颅内高压得到治疗后可能会消失。敏感度恢复的速率或许能揭示初始丧失的原因。我们监测了7例因颅内高压而接受分流手术治疗的患者手术前后的对比敏感度。与正常对照组相比，14只患有视乳头水肿的眼睛中有13只呈现出分流术前特有的敏感度丧失。在分流术后的前3天，敏感度大致维持在分流术前的水平。到分流术后第4至6天，敏感度迅速恢复正常，并在长达1年的时间里保持正常。基于敏感度恢复正常的速率和模式，我们得出结论，初始丧失代表了视神经水平上轴浆淤滞与局部缺血的相互作用。
