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[大脑性全色盲(症状、病程、鉴别诊断及研究策略)。I]

[Cerebral achromatopsia (symptoms, course, differential diagnosis and strategy of the study). I].

作者信息

Jaeger W, Krastel H, Braun S

机构信息

Univ.-Augenklinik, Heidelberg.

出版信息

Klin Monbl Augenheilkd. 1988 Dec;193(6):627-34. doi: 10.1055/s-2008-1050309.

Abstract

To the patient, the sudden onset of cerebral achromatopsia is like switching to black and white on a color TV. As a rule, the defect arises due to bilateral ischemic infarction in the inferior occipitotemporal region. Bilateral upper homonymous quadrantanopsias usually leave the macula more or less unimpaired, so that visual acuity is largely preserved. Prosopagnosia and loss of topographic memory are often associated with central achromatopsia. Investigations of color vision must include color-naming procedures and largefield tests in addition to the conventional methods. Color-naming tasks are indispensable in differentiating cerebral achromatopsia from the aphasic and disconnective types of color anomia. The authors' recommended strategy for investigating color vision relies on records of a case of cerebral achromatopsia obtained six months and two years, respectively, after the onset of symptoms. In addition to the above-mentioned procedures, spectral increment thresholds on white and colored backgrounds were determined. For the first time in cerebral achromatopsia, examinations with large-field spectral matches were performed using the projection anomaloscope. Large-field tests are indispensable for monitoring recovery in cases of central achromatopsia. In the author's patient, recovery of blue-green discrimination was far more complete than that of red-yellow-green discrimination, and for both conditions large-field color vision was far superior to small-field.

摘要

对患者来说,突然出现的脑性全色盲就如同彩色电视机切换到了黑白画面。通常情况下,这种缺陷是由枕颞叶下部双侧缺血性梗死引起的。双侧上象限同向偏盲通常对黄斑的影响较小,因此视力在很大程度上得以保留。面孔失认症和地形记忆丧失常常与中枢性全色盲相关。除了传统方法外,色觉检查必须包括颜色命名程序和大视野测试。颜色命名任务对于区分脑性全色盲与失语性和分离性色觉失认症不可或缺。作者推荐的色觉检查策略依赖于分别在症状出现后六个月和两年获得的一例脑性全色盲病例的记录。除上述程序外,还测定了白色和彩色背景下的光谱增量阈值。首次在脑性全色盲患者中使用投影式色混仪进行大视野光谱匹配检查。大视野测试对于监测中枢性全色盲患者的恢复情况不可或缺。在作者的患者中,蓝绿色辨别能力的恢复远比红黄绿辨别能力的恢复更完全,而且在这两种情况下,大视野色觉都远优于小视野色觉。

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