Department of Neuro-Ophthalmology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India.
Department of Neurology, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India.
J Postgrad Med. 2023 Jan-Mar;69(1):53-55. doi: 10.4103/jpgm.jpgm_1134_21.
Sudden bilateral visual loss because of bilateral lateral geniculate body (LGB) necrosis is a very rare entity. The mechanisms causing these isolated lesions have still not been fully understood. We report a case of sudden loss of vision in a 22-year-old female following an attack of acute pancreatitis, just after starting the paleo diet. Neuroimaging revealed bilateral LGB necrosis. Multidisciplinary approach was sought and she was subsequently managed successfully. On follow-up, her visual acuity showed improvement, and neuroimaging revealed resolution of hyperintensities in bilateral LGB with residual blooming suggestive of old hemorrhagic gliosis. The possible reasons for isolated lesions of the LGB are hemorrhagic infarction and osmotic demyelination. In the present case, we postulate a vascular pathology, possibly hypo-perfusion because of shock following acute pancreatitis.
双侧外侧膝状体（LGB）坏死导致的突发性双侧视力丧失是一种非常罕见的病症。导致这些孤立性病变的机制尚未完全阐明。我们报告了一例 22 岁女性在急性胰腺炎发作后，即开始生酮饮食后出现突发性视力丧失的病例。神经影像学显示双侧外侧膝状体坏死。我们寻求了多学科的治疗方法，并成功对其进行了管理。随访时，她的视力有所改善，神经影像学显示双侧外侧膝状体的高信号已消退，残留的blooming 提示陈旧性出血性胶质增生。孤立性外侧膝状体病变的可能原因是出血性梗死和渗透性脱髓鞘。在本病例中，我们推测是血管病变，可能是由于急性胰腺炎引起的休克导致的低灌注。
