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儿童的红色反射试验和白瞳症。

The Red Reflex Test and Leukocoria in Childhood.

机构信息

Department of Ophthalmology. Unidade Local de Saúde de São João. Porto. Portugal.

Pediatrics Department. Unidade Local de Saúde de São João. Porto. Portugal.

出版信息

Acta Med Port. 2024 Sep 2;37(9):638-646. doi: 10.20344/amp.21367. Epub 2024 Jul 29.

DOI:10.20344/amp.21367
PMID:39074051
Abstract

The red reflex test, performed using a direct ophthalmoscope, serves as a critical diagnostic tool in identifying various ocular conditions. These conditions encompass retinal anomalies (such as retinoblastoma, Coats disease, retinopathy of prematurity, familial exudative vitreoretinopathy, myelinated nerve fibers, ocular toxocariasis, ocular toxoplasmosis, retinochoroidal coloboma, astrocytic, and combined hamartoma), vitreous abnormalities (including persistent fetal vasculature), lens issues (like cataract), anterior chamber and corneal conditions (comprising dysgenesis of the anterior segment, congenital glaucoma, birth trauma), and tear film disturbances. During this examination, the presence of leukocoria, characterized by a white pupillary reflex, can suggest the presence of underlying conditions. Any suspicion of an abnormal red reflex test warrants immediate evaluation by a qualified ophthalmologist. This article primarily underscores the paramount importance of the red reflex examination, not only to identify potential sight-threateningbut also life-threatening conditions. It delves into the most common causes of leukocoria in childhood and offers insights into a comprehensive diagnostic approach. The target audience for this article includes pediatricians, primary care clinicians, and ophthalmologists, all of whom play a pivotal role in the early detection and intervention of these critical eye disorders.

摘要

眼底红光反射检查使用直接检眼镜进行,是识别各种眼部疾病的重要诊断工具。这些疾病包括视网膜异常(如视网膜母细胞瘤、Coats 病、早产儿视网膜病变、家族渗出性玻璃体视网膜病变、髓鞘化神经纤维、眼弓蛔虫病、眼弓形体病、视盘脉络膜缺损、星形细胞瘤和联合性视网膜神经胶质瘤)、玻璃体异常(包括永存原始玻璃体增生症)、晶状体问题(如白内障)、前房和角膜疾病(包括前段发育不良、先天性青光眼、产伤)以及泪膜紊乱。在检查过程中,如果出现白瞳(瞳孔呈现白色的反光),则表明可能存在潜在疾病。任何对异常眼底红光反射检查的怀疑都需要由合格的眼科医生立即进行评估。本文主要强调了眼底红光反射检查的重要性,不仅可以发现潜在的致盲性疾病,还可以发现危及生命的疾病。本文深入探讨了儿童白瞳的最常见原因,并提供了全面诊断方法的见解。本文的目标读者包括儿科医生、初级保健临床医生和眼科医生,他们在这些严重眼部疾病的早期发现和干预中都起着关键作用。

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