Lestak Jan, Prazakova Lenka, Fus Martin, Kyncl Martin
Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, 272 01, Czech Republic.
Int Med Case Rep J. 2024 Oct 9;17:835-841. doi: 10.2147/IMCRJ.S479333. eCollection 2024.
The case report of a young myope (born in 1997) who was diagnosed with bilateral concentric narrowing of the visual field to 15-20 degrees in 2021 is presented. On eye fundus, the findings were normal with central excavation c/d=0.5 and 0.4, respectively. OCT showed loss of retinal nerve fiber layer - in both vertical quadrants, including a reduction in the ganglion cell complex. Electrophysiological examination (PERG) showed normal retinal responses. Visual evoked responses (PVEP) after stimulation squared a 1 degree decrease in amplitudes, with no prolongation of P100 latency. When stimulated with 15-minute squares, responses were normal (see Supplementary Figure). Magnetic resonance imaging of the brain showed a narrowing of the chiasm. In conclusion, optic chiasm hypoplasia may not always have distinct morphological and functional manifestations. In addition to imaging methods, electrophysiological examination of the visual analyser was of great help for its verification.
本文报告了一例年轻近视患者(出生于1997年)的病例,该患者于2021年被诊断为双眼视野向心性缩窄至15 - 20度。眼底检查结果正常,中央凹陷c/d分别为0.5和0.4。光学相干断层扫描(OCT)显示视网膜神经纤维层在两个垂直象限均有缺失,包括神经节细胞复合体减少。电生理检查(图形视网膜电图,PERG)显示视网膜反应正常。刺激后视觉诱发电位(PVEP)的振幅下降了1度,P100潜伏期无延长。当用15分钟的方块刺激时,反应正常(见补充图)。脑部磁共振成像显示视交叉变窄。总之,视交叉发育不全可能并不总是具有明显的形态学和功能表现。除了成像方法外,视觉分析仪的电生理检查对其诊断有很大帮助。