Chang En-Che, Huang Jing-Shan, Hou Yu-Chih, Huang Chu-Hsuan, Wang I-Hua
Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
Department of Surgery, Cathay General Hospital, Taipei, Taiwan.
Taiwan J Ophthalmol. 2022 Mar 10;12(3):354-359. doi: 10.4103/tjo.tjo_54_21. eCollection 2022 Jul-Sep.
A 48-year-old woman presented with persistent clouding vision in her lower field in the right eye for 5 months. A small retinal hemorrhage was initially reported. Her visual acuity was 20/30 in the right eye and 20/20 in the left, with normal color vision and pupil response. Fundus examination did not reveal any retinal hemorrhage. Although optical coherence tomography (OCT) showed normal macula and retinal nerve fiber layers in both eyes, asymmetric thinning of the ganglion cell inner plexiform layer was found in the superior macula of the right eye in ganglion cell analysis (GCA). Visual field examination revealed a subtle inferonasal scotoma. Compressive optic neuropathy (CON) was suspected. The visual evoked potential test revealed delayed P100 latency. A tuberculum sellae meningioma was found with right medial optic canal extension. The visual acuity of the right eye returned to 20/25 after decompression surgery. OCT can be used to differentiate between retinopathy and optic neuropathy. GCA can help in the early detection of CON and achieve a good visual outcome after surgery.
一名48岁女性因右眼下方视野持续模糊5个月前来就诊。最初报告有少量视网膜出血。她右眼视力为20/30，左眼视力为20/20，色觉和瞳孔反应正常。眼底检查未发现任何视网膜出血。尽管光学相干断层扫描（OCT）显示双眼黄斑和视网膜神经纤维层正常，但在神经节细胞分析（GCA）中发现右眼黄斑上方神经节细胞内丛状层不对称变薄。视野检查发现一个细微的鼻下暗点。怀疑为压迫性视神经病变（CON）。视觉诱发电位测试显示P100潜伏期延迟。发现鞍结节脑膜瘤并延伸至右侧视神经管。减压手术后右眼视力恢复到20/25。OCT可用于区分视网膜病变和视神经病变。GCA有助于早期发现CON并在手术后取得良好的视力结果。
