Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.
Ophthalmic Plast Reconstr Surg. 2013 Jul-Aug;29(4):e98-e101. doi: 10.1097/IOP.0b013e31827defc7.
Gaze-evoked amaurosis (GEA) is a transient monocular vision loss provoked by eccentric gaze. Gaze-evoked amaurosis has been associated with a variety of orbital lesions, most commonly optic nerve sheath meningiomas and cavernous hemangiomas. The authors describe the first report in the literature of GEA as the presenting symptom of an orbital metastasis. The patient was a 47-year-old woman with a history of breast cancer with no known history of metastasis or active disease who presented with several weeks of vision loss in the OD upon rightward gaze. She was found to have enophthalmos and optic disc edema of the OD. Imaging revealed an intraorbital lesion, and a biopsy was consistent with a scirrhous metastasis of her breast carcinoma. This case highlights the importance of considering orbital metastases among the differential for gaze-evoked amaurosis.
眼动诱发性黑矇（GEA）是一种由斜视引起的短暂性单眼视力丧失。眼动诱发性黑矇与多种眼眶病变有关，最常见的是视神经鞘脑膜瘤和海绵状血管瘤。作者描述了文献中首例以眼动诱发性黑矇为首发症状的眼眶转移瘤。患者为 47 岁女性，有乳腺癌病史，无已知转移或活动性疾病史，表现为右眼向右凝视时数周视力丧失。检查发现右眼眼球内陷和视盘水肿。影像学显示眶内病变，活检符合乳腺癌硬癌转移。本病例强调了在鉴别诊断中考虑眼眶转移瘤对于眼动诱发性黑矇的重要性。
