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毛细胞型星形细胞瘤导致的急性产后视力丧失。

Acute post-partum vision loss due to pilocytic astrocytoma.

作者信息

Homer Natalie A, Epstein Aliza, Durairaj Vikram D, Wang Min, Jonna Gowtham, Somogyi Marie

机构信息

TOC Eye and Face, 3705 Medical Parkway, Suite 120, Austin, TX, 78705, USA.

Department of Ophthalmology, Dell Medical School, University of Texas at Austin, 1501 Red River St, Austin, TX, 78701, USA.

出版信息

Am J Ophthalmol Case Rep. 2020 Aug 20;20:100897. doi: 10.1016/j.ajoc.2020.100897. eCollection 2020 Dec.

Abstract

PURPOSE

We report an unusual case of a thirty-three-year-old woman who presented with acute unilateral vision loss following pregnancy and was ultimately discovered to have a pilocytic astrocytoma of the optic nerve.

OBSERVATIONS

A thirty-three-year-old previously healthy female presented one month following Caesarean section with unilateral vision loss. She was found to have significantly decreased visual acuity, an afferent pupil deficit, proptosis, optic nerve edema and choroidal folds. Imaging revealed a large lesion of the optic nerve. Biopsy was performed and pathologic analysis revealed a pilocytic astrocytoma, WHO grade 1. The patient opted for close observation without further management and demonstrated mild improvement in visual function.

CONCLUSIONS/IMPORTANCE: Optic pathway gliomas (OPG) most commonly present in the pediatric patient population with painless proptosis, slowly progressive vision loss, and clinical findings of chronic optic neuropathy.( Farazdaghi et al., 2019 Sep) 1 Acute presentations of this disease in adulthood are rare. This case demonstrates a rare case of acute optic nerve glioma presentation during the post-partum period.

摘要

目的

我们报告一例罕见病例,一名33岁女性在产后出现急性单侧视力丧失,最终被诊断为视神经毛细胞型星形细胞瘤。

观察结果

一名33岁、既往健康的女性在剖宫产术后1个月出现单侧视力丧失。检查发现其视力显著下降、传入性瞳孔缺陷、眼球突出、视神经水肿和脉络膜皱褶。影像学检查显示视神经有一个大的病变。进行了活检,病理分析显示为WHO 1级毛细胞型星形细胞瘤。患者选择密切观察而不进行进一步治疗,其视觉功能有轻度改善。

结论/意义:视神经胶质瘤(OPG)最常见于儿童患者,表现为无痛性眼球突出、视力缓慢进行性丧失以及慢性视神经病变的临床表现。(法拉兹达吉等人,2019年9月)1 该疾病在成年期的急性表现罕见。本病例展示了产后急性视神经胶质瘤表现的罕见病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49e0/7452090/405dbdddd379/gr1.jpg

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