Knox D L, Hanneken A M, Hollows F C, Miller N R, Schick H L, Gonzales W L
Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD 21205.
Arch Ophthalmol. 1988 Jan;106(1):50-4. doi: 10.1001/archopht.1988.01060130056027.
Vision loss progressing over several days, reduced pupil reactions to light, and swollen optic nerves were the clinical features in six patients with severe renal disease manifested by uremia, anemia, and (in four patients) moderately or severely elevated blood pressure. In two patients pale edema of the optic nerve head extended into the macula. One patient with renal transplant rejection was in the early phases of cryptococcal meningitis that went undiagnosed for two weeks. Medical management with hemodialysis was followed by improvement of vision in four patients. In one patient, resumption of oral corticosteroid therapy was followed by improvement in vision. The patient whose vision improved the most rapidly was managed by prompt use of both dialysis and oral corticosteroid therapy. The patient with cryptococcal meningitis did not recover vision.
视力在数天内逐渐丧失、瞳孔对光反应减弱以及视神经肿胀，这些是6例严重肾病患者的临床特征，这些患者表现为尿毒症、贫血，其中4例患者血压中度或重度升高。2例患者视乳头苍白水肿延伸至黄斑区。1例肾移植排斥患者处于隐球菌性脑膜炎早期，两周内未被诊断出来。4例患者接受血液透析药物治疗后视力改善。1例患者恢复口服皮质类固醇治疗后视力改善。视力改善最快的患者通过及时使用透析和口服皮质类固醇治疗。隐球菌性脑膜炎患者视力未恢复。
