Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Curr Neurol Neurosci Rep. 2024 Aug;24(8):273-284. doi: 10.1007/s11910-024-01349-8. Epub 2024 Jun 22.
To review the literature on visual dysfunction in dementia with Lewy bodies (DLB), including its mechanisms and clinical implications.
Recent studies have explored novel aspects of visual dysfunction in DLB, including visual texture agnosia, mental rotation of 3-dimensional drawn objects, and reading fragmented letters. Recent studies have shown parietal and occipital hypoperfusion correlating with impaired visuoconstruction performance. While visual dysfunction in clinically manifest DLB is well recognized, recent work has focused on prodromal or mild cognitive impairment (MCI) due to Lewy body pathology with mixed results. Advances in retinal imaging have recently led to the identification of abnormalities such as parafoveal thinning in DLB. Patients with DLB experience impairment in color perception, form and object identification, space and motion perception, visuoconstruction tasks, and illusions in association with visual cortex and network dysfunction. These symptoms are associated with visual hallucinations, driving impairment, falls, and other negative outcomes.
综述路易体痴呆(DLB)患者视觉功能障碍的文献,包括其发病机制和临床意义。
近期研究探讨了 DLB 患者视觉功能障碍的新方面,包括视觉纹理失认症、3D 绘制物体的心理旋转以及阅读碎片化字母。近期研究表明,顶叶和枕叶灌注不足与视觉结构表现受损相关。尽管临床上明显的 DLB 患者的视觉功能障碍已得到充分认识,但由于路易体病导致的前驱期或轻度认知障碍(MCI)的研究最近有所增加,但结果喜忧参半。视网膜成像技术的进步最近导致发现了 DLB 患者的旁中心区变薄等异常。DLB 患者在颜色感知、形状和物体识别、空间和运动感知、视觉结构任务以及与视觉皮层和网络功能障碍相关的错觉方面存在障碍。这些症状与视觉幻觉、驾驶障碍、跌倒和其他负面结果相关。