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[儿童白内障 - 第1部分:诊断与术前管理]

[Cataract in childhood-Part 1 : Diagnostics and preoperative management].

作者信息

Kuhli-Hattenbach Claudia, Wenner Yaroslava, Fronius Maria, Dávidová Petra, Kohnen Thomas

机构信息

Klinik für Augenheilkunde, Klinikum der Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

出版信息

Ophthalmologie. 2025 May;122(5):410-418. doi: 10.1007/s00347-025-02242-6. Epub 2025 Apr 30.

DOI:10.1007/s00347-025-02242-6
PMID:40304738
Abstract

Cataract in childhood can be associated with a high amblyogenic risk depending on the age at onset, extent of lens opacity and cataract laterality and accompanying ocular diseases. Early diagnosis and initiation of adequate treatment of a cataract in childhood are essential for a favorable long-term development of visual acuity. The decision for or against surgical treatment is essentially dependent on the estimation of the individual amblyogenic risk. This article provides an overview of relevant publications and own research data and therefore the current state of research on the topics etiology, symptoms, amblyogenic risk and diagnostics of pediatric cataract. This article focuses on conspicuous symptoms and the importance and performance of diagnostic methods including the Bruckner test, funduscopy without pupil dilation and adequate visual acuity testing in preverbal children. The assessment of the individual risk of amblyopia and possible long-term functional and morphological results represent the basis for treatment planning of cataract in childhood.

摘要

儿童白内障根据发病年龄、晶状体混浊程度、白内障的单侧或双侧情况以及伴随的眼部疾病,可能具有较高的致弱视风险。儿童白内障的早期诊断和及时进行适当治疗对于视力的良好长期发育至关重要。决定是否进行手术治疗主要取决于对个体致弱视风险的评估。本文概述了相关出版物和自身研究数据,以及目前关于儿童白内障的病因、症状、致弱视风险和诊断等主题的研究现状。本文重点关注明显症状以及诊断方法的重要性和应用,包括布鲁克纳试验、不散大瞳孔的眼底检查以及对尚不能言语儿童进行的适当视力测试。对个体弱视风险以及可能的长期功能和形态学结果的评估是儿童白内障治疗计划的基础。

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[Cataract in childhood-Part 1 : Diagnostics and preoperative management].[儿童白内障 - 第1部分:诊断与术前管理]
Ophthalmologie. 2025 May;122(5):410-418. doi: 10.1007/s00347-025-02242-6. Epub 2025 Apr 30.
2
[Examination methods in the diagnosis of uni- and bilateral cataracts in childhood].[儿童单侧及双侧白内障诊断中的检查方法]
Ophthalmologe. 2007 Jul;104(7):552-8. doi: 10.1007/s00347-007-1556-3.
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[Infantile cataract and surgical management].[婴儿白内障与手术治疗]
J Fr Ophtalmol. 2011 Mar;34(3):192-7. doi: 10.1016/j.jfo.2011.01.002. Epub 2011 Mar 5.
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Acta Ophthalmol. 2019 Aug;97(5):486-490. doi: 10.1111/aos.13966. Epub 2018 Nov 2.
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[Treatment of congenital and early childhood cataract].[先天性及儿童早期白内障的治疗]
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Treatment of congenital and early childhood cataract.先天性和婴幼儿期白内障的治疗。
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Surgical interventions for bilateral congenital cataract in children aged two years and under.儿童两岁及以下双侧先天性白内障的手术干预。
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本文引用的文献

1
[Treatment of congenital and early childhood cataract].[先天性及儿童早期白内障的治疗]
Ophthalmologe. 2020 Oct;117(10):1049-1060. doi: 10.1007/s00347-020-01232-0.
2
Inherited cataracts: molecular genetics, clinical features, disease mechanisms and novel therapeutic approaches.遗传性白内障:分子遗传学、临床特征、发病机制和新的治疗方法。
Br J Ophthalmol. 2020 Oct;104(10):1331-1337. doi: 10.1136/bjophthalmol-2019-315282. Epub 2020 Mar 25.
3
Long-term Effect of Intraocular Lens vs Contact Lens Correction on Visual Acuity After Cataract Surgery During Infancy: A Randomized Clinical Trial.
婴儿期白内障手术后眼内晶状体与接触镜矫正对视力的长期影响:一项随机临床试验。
JAMA Ophthalmol. 2020 Apr 1;138(4):365-372. doi: 10.1001/jamaophthalmol.2020.0006.
4
[Timing of congenital cataract surgery : Amblyopia versus aphakic glaucoma].[先天性白内障手术时机:弱视与无晶状体性青光眼]
Ophthalmologe. 2020 Mar;117(3):190-198. doi: 10.1007/s00347-020-01053-1.
5
Risk of aphakic glaucoma after pars plana-lensectomy with and without removal of the peripheral lens capsule.后房型巩膜切除术联合或不联合周边晶状体囊切除术治疗无晶状体眼青光眼的风险。
Eye (Lond). 2019 Sep;33(9):1472-1477. doi: 10.1038/s41433-019-0435-x. Epub 2019 Apr 10.
6
Treatment results in aphakic patients with glaucoma following congenital cataract surgery.先天性白内障手术后无晶状体性青光眼患者的治疗结果。
Int Ophthalmol. 2019 Jan;39(1):11-19. doi: 10.1007/s10792-017-0777-y. Epub 2017 Nov 30.
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Update on congenital cataract surgery management.先天性白内障手术治疗的最新进展。
Curr Opin Ophthalmol. 2017 Jan;28(1):87-92. doi: 10.1097/ICU.0000000000000324.
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Congenital cataract associated with persistent fetal vasculature: findings from IoLunder2.与永存原始玻璃体增生症相关的先天性白内障:来自IoLunder2的研究结果
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9
Associated systemic and ocular disorders in patients with congenital unilateral cataracts: the Infant Aphakia Treatment Study experience.先天性单侧白内障患者的相关全身和眼部疾病:婴儿无晶状体治疗研究经验。
Eye (Lond). 2016 Sep;30(9):1170-4. doi: 10.1038/eye.2016.124. Epub 2016 Jun 17.
10
Diagnosing the cause of bilateral paediatric cataracts: comparison of standard testing with a next-generation sequencing approach.诊断小儿双侧白内障的病因:标准检测与新一代测序方法的比较
Eye (Lond). 2016 Sep;30(9):1175-81. doi: 10.1038/eye.2016.105. Epub 2016 Jun 17.