Yoshii M, Okisaka S, Yanagawa Y, Takiguchi H
Department of Ophthalmology, National Defense Medical College, Saitama-ken, Japan.
Nippon Ganka Gakkai Zasshi. 1995 Jun;99(6):739-44.
A case of optic neuropathy after postoperative radiation therapy is reported. A 69-year-old woman had a partial resection of a pituitary adenoma in 1990 and was treated with 45Gy of irradiation to the postoperative pituitary lesion for one month. Seven months later she had sudden right visual field loss. Goldmann perimetry examination revealed remarked visual field defect in her right eye with visual acuity of 1.0. The right relative afferent pupillary defect was positive. The value of critical flicker fusion for her right eye was reduced and the amplitude of steady-state pattern-reversal visually evoked cortical potential was significantly less for the right monocular stimulation than that for the fellow eye stimulation, but Ganzfeld electroretinograms were normal for both eyes. Magnetic resonance imaging using Gadolinium-diethylene triaminepenta-acetic acid revealed enhancement on the right optic nerve, which had not been recognized immediately after the radiation therapy, without any suggestion of right optic nerve compression by the residual pituitary adenoma.
报告了一例术后放射治疗后发生视神经病变的病例。一名69岁女性于1990年接受了垂体腺瘤部分切除术，并对术后垂体病变进行了为期一个月的45Gy放射治疗。七个月后，她突然出现右侧视野缺损。Goldmann视野检查显示其右眼有明显的视野缺损，视力为1.0。右侧相对性传入性瞳孔障碍呈阳性。其右眼的临界闪烁融合值降低，右眼单眼刺激时稳态模式反转视觉诱发电位的波幅明显低于对侧眼刺激时，但双眼的闪光视网膜电图均正常。使用钆二乙烯三胺五乙酸的磁共振成像显示右侧视神经有强化，这在放射治疗后未立即被发现，且没有任何残余垂体腺瘤压迫右侧视神经的迹象。
