Sundaram Arun N E, Abhayambika Archana, Kumar Sunil
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Neuroophthalmology. 2017 May 10;41(6):321-325. doi: 10.1080/01658107.2017.1315145. eCollection 2017 Dec.
Renal osteodystrophy can cause calvarial hypertrophy and narrowing of the neural canals and foramina. Compressive optic neuropathy is extremely rare in renal osteodystrophy and was reported once only. The authors report bilateral, simultaneous compressive optic neuropathy secondary to renal osteodystrophy with features of uremic leontiasis ossea in chronic renal failure caused by branchio-oto-renal syndrome. Because of the extensive calvarial hypertrophy and the surgical difficulties envisaged with optic canal decompression, conservative approach was pursued. The patient's visual acuity and fields improved after partial parathyroidectomy. Visual improvement may be explained by the arrest of renal osteodystrophy and reduced optic nerve compression after parathyroidectomy.
肾性骨营养不良可导致颅骨肥厚以及神经管和神经孔狭窄。压迫性视神经病变在肾性骨营养不良中极为罕见，仅曾有过一次报道。作者报告了一例继发于肾性骨营养不良的双侧同时性压迫性视神经病变，该病变具有鳃-耳-肾综合征所致慢性肾衰竭的尿毒症性骨性狮面征特征。由于广泛的颅骨肥厚以及预计视神经管减压手术存在困难，故采取了保守治疗方法。患者在部分甲状旁腺切除术后视力和视野得到改善。视力改善可能是由于肾性骨营养不良得到控制以及甲状旁腺切除术后视神经压迫减轻所致。
