Volkers E J, Donders R C J M, Algra A, Kapelle L J
Universitair Medisch Centrum Utrecht, Utrecht.
Ned Tijdschr Geneeskd. 2017;161:D1188.
Transient monocular vision loss (TMVL) caused by temporary disturbance of blood flow to the retina is a harbinger of future vascular complications. The diagnosis may be difficult, not only because it is solely dependent on history taking, but also because the range of monocular visual symptoms a patient may experience is wide. The classic pattern of a sudden black or grey visual field, or a curtain that is drooping in front of one eye, easily fits in the diagnosis of TMVL; however, coloured vision or flashes should not always be considered as benign. The distinction between visual symptoms of one or both eyes should receive attention during history taking. It is the professional expertise of the neurologist and ophthalmologist which should make it possible to establish the correct diagnosis. A patient suspected of a retinal TIA should be evaluated and treated with the same urgency as someone with a cerebral TIA.
由视网膜血流暂时紊乱引起的短暂性单眼视力丧失(TMVL)是未来血管并发症的先兆。诊断可能困难,不仅因为它完全依赖于病史采集,还因为患者可能经历的单眼视觉症状范围很广。突然出现黑色或灰色视野、或一只眼前有幕布下垂的典型症状,很容易诊断为TMVL;然而,色觉或闪光并不总是应被视为良性。在病史采集过程中,应注意区分单眼或双眼的视觉症状。神经科医生和眼科医生的专业知识应有助于做出正确诊断。怀疑有视网膜短暂性脑缺血发作(TIA)的患者应与有脑TIA的患者一样紧急进行评估和治疗。