Sherman J, Bodis-Wollner I, Milch F, Goldstein J, Brannan J
State University of New York State College of Optometry, New York 10010.
J Am Optom Assoc. 1993 Jul;64(7):475-8.
The ocular and visual manifestations of multiple sclerosis are varied. The most uncommon is sheathing of the veins, periphlebitis.
A 39-year-old white female presented with primary visual complaints of contrast problems on a computer terminal. The patient was lost to follow up for 4 years, however, upon return a clinical diagnosis of multiple sclerosis was confirmed. Six years after the initial presentation, ophthalmoscopic exam of both eyes revealed marked focal sheathing of the retinal veins in the periphery, and associated hemorrhages in the right eye.
During follow-up, the left eye became further involved developing hemorrhages and a retinal hole, which was treated. The visual consequence of the multiple sclerosis as a result of further exacerbations were bilateral centrocecal scotomas and midly reduced visual acuity.
Multiple sclerosis should be considered in the differential diagnosis of patients with retinal periphlebitis.
多发性硬化的眼部和视觉表现多种多样。最不常见的是静脉鞘形成，即静脉周围炎。
一名39岁的白人女性因在电脑终端上出现对比度问题的主要视觉症状前来就诊。该患者失访4年，但复诊时确诊为多发性硬化。初次就诊6年后，双眼眼底检查发现周边视网膜静脉有明显的局灶性鞘膜形成，右眼伴有出血。
随访期间，左眼病情进一步发展，出现出血和视网膜裂孔，并接受了治疗。多发性硬化进一步加重导致的视觉后果是双侧中心暗点和视力轻度下降。
在视网膜静脉周围炎患者的鉴别诊断中应考虑多发性硬化。
