Piltz J R, Wertenbaker C, Lance S E, Slamovits T, Leeper H F
Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia.
J Clin Neuroophthalmol. 1993 Dec;13(4):275-80.
We report three cases of digoxin toxicity presenting with decreased visual acuity, unaccompanied by the classic visual symptom of xanthopsia. Visual function improved and symptoms diminished upon lowering of blood digoxin level. Electroretinographic (ERG) abnormalities in the first case were suggestive of a cone deficit, which supports recent electrodiagnostic and labeled tracer studies implicating retinal dysfunction in the pathogenesis of digoxin toxicity. The second patient presented with visual symptoms exclusively. Evaluation of the third case was hampered by advanced retinitis pigmentosa and the presentation was complicated by a syncopal episode. Digoxin toxicity is a potentially life-threatening condition. Ophthalmologists and neurologists may be the first physicians consulted. It must be considered in the differential diagnosis in patients with otherwise unexplained visual loss.
我们报告了3例地高辛中毒病例，这些病例均表现为视力下降，但无典型的视黄视症视觉症状。降低血液中地高辛水平后，视觉功能改善，症状减轻。第一例患者的视网膜电图（ERG）异常提示存在视锥细胞缺陷，这支持了最近的电诊断和标记示踪剂研究，这些研究表明视网膜功能障碍在地高辛中毒的发病机制中起作用。第二例患者仅出现视觉症状。第三例患者的评估因晚期色素性视网膜炎而受阻，且该病例因晕厥发作而病情复杂。地高辛中毒是一种潜在的危及生命的疾病。眼科医生和神经科医生可能是首先被咨询的医生。对于原因不明的视力丧失患者，在鉴别诊断中必须考虑到该病。
