Rougier M-B
Service d'ophtalmologie, CHU de Bordeaux, place Amelie-Raba-Léon, 33000 Bordeaux, France; Inserm, U1219, Bordeaux Population Health Research Center, 33000 Bordeaux, France.
J Fr Ophtalmol. 2017 May;40(5):422-429. doi: 10.1016/j.jfo.2017.02.002. Epub 2017 May 6.
This article will review the current standard of care in the diagnosis and management of bilateral optic disc edema. Two emergent conditions must be considered first: secondary intracranial hypertension (cerebral tumor, cerebral thrombophlebitis…) and arteritic ischemic optic neuropathy (or giant cell arteritis). Having ruled out these two diagnoses, the management follows various steps in order to: (i) rule out pseudo-edema, and (ii) determine the underlying cause of the edema: papilledema, non-arteritic ischemic optic neuropathy or papillitis. Systematic cerebral imaging with contrast is required.
本文将综述双侧视盘水肿诊断和管理的当前护理标准。首先必须考虑两种紧急情况:继发性颅内高压(脑肿瘤、脑静脉血栓炎……)和动脉炎性缺血性视神经病变(或巨细胞动脉炎)。排除这两种诊断后,管理遵循以下几个步骤,以便:(i)排除假性水肿,以及(ii)确定水肿的潜在原因:视乳头水肿、非动脉炎性缺血性视神经病变或视乳头炎。需要进行系统性的增强脑部成像。