Department of Neurology, University of Massachusetts Chan Medical School, 55 Lake Ave N, Worcester, MA, 01655, U.S.A..
Department of Neurology, University of Massachusetts Chan Medical School, 55 Lake Ave N, Worcester, MA, 01655, U.S.A.
Neurol Sci. 2023 Oct;44(10):3481-3493. doi: 10.1007/s10072-023-06818-5. Epub 2023 Apr 22.
Case presentation of acute onset bilateral painless vision loss caused by bilateral infarction of the lateral geniculate bodies (LGB) and a systematic review of the literature.
A descriptive case report is presented on a 17-year-old female diagnosed with acute pancreatitis who developed acute onset bilateral painless vision loss. A systematic literature review of cases with bilateral LGB lesions was conducted across three electronic databases (PubMed/PubMed Central/MEDLINE, Scopus, and ScienceDirect). The review was conducted in concordance with PRISMA guidelines and prospectively registered on PROSPERO (CRD42022362491).
The reported 17-year-old female was found to have MRI findings consistent with bilateral hemorrhagic infarction of the LGB and Purtscher-like retinopathy. A systematic literature review of bilateral LGB infarction yielded 23 records for analysis. 19/23 (82.6%) of reported cases occurred in women. Bilateral vision loss was noted in all cases. The average reported age was 27 years old with a range from 2-50. Gastrointestinal pathology (e.g., pancreatitis, gastroenteritis) was present in 8/23 (34.7%) of cases. 8/23 (34.7%) cases had neuroimaging or pathological evidence of hemorrhagic transformation of the infarct. Most cases experienced partial recovery of visual loss; only one case (4.7%) had complete visual recovery. 9/23 (39.1%) cases were reported from the United States and 4/23 (17.3%) from India.
Bilateral LGB lesion is a rare cause of vision loss, typically caused by systemic diseases and with female preponderance. Purported pathophysiology relates to increased vulnerability of the LGB to ischemic and metabolic stress.
双侧外侧膝状体梗死导致双侧突发性无痛性视力丧失的病例报告,并对文献进行系统回顾。
我们报告了一例 17 岁女性病例,该患者诊断为急性胰腺炎,发病时出现双侧突发性无痛性视力丧失。我们对三个电子数据库(PubMed/PubMed Central/MEDLINE、Scopus 和 ScienceDirect)中双侧外侧膝状体病变的病例进行了系统文献回顾。该综述符合 PRISMA 指南,并在 PROSPERO(CRD42022362491)上进行了前瞻性注册。
报告的 17 岁女性患者的 MRI 结果符合双侧外侧膝状体出血性梗死和 Purtscher 样视网膜病变。对双侧外侧膝状体梗死的系统文献回顾得出 23 份可供分析的记录。报告的病例中有 19/23(82.6%)发生在女性。所有病例均出现双侧视力丧失。平均报告年龄为 27 岁,范围为 2-50 岁。8/23(34.7%)的病例存在胃肠道病理(如胰腺炎、胃肠炎)。8/23(34.7%)的病例有神经影像学或病理学证据表明梗死发生了出血性转化。大多数病例的视力丧失部分恢复;只有 1 例(4.7%)完全恢复了视力。23 例中有 9/23(39.1%)来自美国,4/23(17.3%)来自印度。
双侧外侧膝状体病变是视力丧失的罕见原因,通常由系统性疾病引起,且女性发病率较高。推测的病理生理学与外侧膝状体对缺血和代谢应激的易感性增加有关。