Serova N K, Grigoreva N N, Khavboshina A G, Butenko E I
N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia.
Vestn Oftalmol. 2020;136(4):39-46. doi: 10.17116/oftalma202013604139.
To analyze neuro-ophthalmology symptoms in patients with germinomas located in pineal and suprasellar regions.
The study analyzed 133 patients with germinoma who were receiving treatment in Burdenko Neuro-surgical Institute from 2008 to 2017. Assessment of results was performed by neuro-ophthalmology examination, a computerized oculograph was used for the objectification of the severity of ocular-motor and pupillary disorders.
Among the patients of the study, 65 had pineal germinoma, 42 - suprasellar germinoma and 26 - bifocal germinoma. Among patients with pineal germinomas, males prevailed, while more females had suprasellar germinomas. No statistical difference was found between gender and bifocal germinoma. Pineal germinomas were manifested predominantly by the development of the dorsal midbrain syndrome in the form of oculomotor and pupillary dysfunction (75%) and the development of papilledema (53%). Germinomas of suprasellar localization are most often presented by asymmetric chiasmatic syndrome (24%). Dorsal midbrain syndrome in patients with bifocal germinomas was detected in 76% cases, combination of oculomotor and pupillary dysfunction with visual impairments was found in 38% cases. Neuro-ophthalmological symptoms of germinoma of these regions manifest in the early stages of the disease and require ophthalmological examination during all stages of diagnosis and treatment.
分析松果体区和鞍上区生殖细胞瘤患者的神经眼科症状。
本研究分析了2008年至2017年在布尔坚科神经外科研究所接受治疗的133例生殖细胞瘤患者。通过神经眼科检查评估结果，使用电脑眼动仪客观评估眼动和瞳孔障碍的严重程度。
在本研究患者中，65例为松果体生殖细胞瘤，42例为鞍上生殖细胞瘤，26例为双灶性生殖细胞瘤。松果体生殖细胞瘤患者中男性居多，而鞍上生殖细胞瘤患者中女性更多。性别与双灶性生殖细胞瘤之间未发现统计学差异。松果体生殖细胞瘤主要表现为动眼神经和瞳孔功能障碍形式的中脑背侧综合征（75%）以及视乳头水肿（53%）。鞍上生殖细胞瘤最常表现为不对称性视交叉综合征（24%）。双灶性生殖细胞瘤患者中76%出现中脑背侧综合征，38%出现动眼神经和瞳孔功能障碍与视力损害的组合。这些区域生殖细胞瘤的神经眼科症状在疾病早期出现，在诊断和治疗的各个阶段都需要眼科检查。
