Hamed L M, Winward K E, Glaser J S, Schatz N J
Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.
Am J Ophthalmol. 1989 Jul 15;108(1):30-5. doi: 10.1016/s0002-9394(14)73256-8.
We examined three patients who developed optic neuropathies while undergoing chronic hemodialysis. One patient developed severe bilateral deterioration of vision, but recovered totally four weeks after discontinuing deferoxamine chelation therapy. Another patient had bilateral visual loss associated with chronic papilledema of idiopathic increased intracranial pressure. A third showed atypically severe consecutive anterior ischemic optic neuropathy. The latter two patients showed little improvement with high-dose intravenous methylprednisolone therapy combined with more vigorous hemodialysis. These cases, in addition to those previously described, underscore the heterogeneity of optic nerve disease in patients with uremia.
我们检查了三名在进行慢性血液透析时发生视神经病变的患者。一名患者出现严重的双侧视力减退,但在停止去铁胺螯合治疗四周后完全康复。另一名患者出现双侧视力丧失,伴有特发性颅内压升高引起的慢性视乳头水肿。第三名患者表现为非典型的严重连续性前部缺血性视神经病变。后两名患者在接受大剂量静脉注射甲基强的松龙治疗并加强血液透析后改善甚微。这些病例,连同先前描述的病例,强调了尿毒症患者视神经疾病的异质性。