Armstrong Richard A
Vision Sciences, Aston University, Birmingham, United Kingdom.
Int Rev Neurobiol. 2017;134:921-946. doi: 10.1016/bs.irn.2017.04.007. Epub 2017 May 31.
This chapter describes the visual problems likely to be encountered in Parkinson's disease (PD) and whether such signs are useful in differentiating the parkinsonian syndromes. Visual dysfunction in PD may involve visual acuity, contrast sensitivity, color discrimination, pupil reactivity, saccadic and pursuit eye movements, motion perception, visual fields, and visual processing speeds. In addition, disturbance of visuospatial orientation, facial recognition problems, rapid eye movement (REM) sleep behavior disorder, and chronic visual hallucinations may be present. Problems affecting pupil reactivity, stereopsis, pursuit eye movement, and visuomotor adaptation, when accompanied by REM sleep behavior disorder, could be early features of PD. Dementia associated with PD is associated with enhanced eye movement problems, visuospatial deficits, and visual hallucinations. Visual dysfunction may be a useful diagnostic feature in differentiating PD from other parkinsonian symptoms, visual hallucinations, visuospatial dysfunction, and variation in saccadic eye movement problems being particularly useful discriminating features.
本章描述了帕金森病（PD）可能出现的视觉问题，以及这些体征是否有助于鉴别帕金森综合征。帕金森病中的视觉功能障碍可能涉及视力、对比敏感度、颜色辨别、瞳孔反应、扫视和追踪眼球运动、运动感知、视野以及视觉处理速度。此外，可能存在空间定向障碍、面部识别问题、快速眼动（REM）睡眠行为障碍和慢性视幻觉。当伴有快速眼动睡眠行为障碍时，影响瞳孔反应、立体视觉、追踪眼球运动和视觉运动适应的问题可能是帕金森病的早期特征。与帕金森病相关的痴呆与眼球运动问题加剧、空间视觉缺陷和视幻觉有关。视觉功能障碍可能是区分帕金森病与其他帕金森症状的有用诊断特征，视幻觉、空间视觉功能障碍以及扫视眼球运动问题的变化是特别有用的鉴别特征。
