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[儿童2型神经纤维瘤病的眼科表现]

[Ophthalmologic spectrum of neurofibromatosis type 2 in childhood].

作者信息

Mautner V F, Hazim W, Pohlmann K, Berger R, Kluwe L, Haase W

机构信息

Neurologische Abteilung, Allgemeines Krankenhaus Ochsenzoll, Hamburg.

出版信息

Klin Monbl Augenheilkd. 1996 Jan;208(1):58-62. doi: 10.1055/s-2008-1035169.

Abstract

BACKGROUND

Neurofibromatosis type 2 (NF2) is a disorder with autosomal dominant inheritance which leads to tumor growth in the central and peripheral nervous system. In affected adult patients there is a typical association with ocular abnormalities like juvenile cataract.

METHODS

Ophthalmologic investigation was carried out in ten children aged one to fourteen years with suspected NF2. The diagnosis was confirmed by further clinical examination and-in one patient-by segregation analysis.

RESULTS

Nine of these ten children showed ocular abnormalities such as juvenile subcapsular cataracts, retinal hamartomas, optic nerve sheath tumors, fibrotic maculopathies as well as one case of a perineural calcification of the optic nerve and one case of a cerebral hamartoma on the ground of the third ventricle.

DISCUSSION

In six children ophthalmological symptoms were the presenting symptom of the disease. The knowledge of these symptoms allows for the diagnosis of NF2 in children who present with isolated ocular deficits or with other typical criteria of the disease. The early diagnosis of the disease may lead to an improved prognosis with regard to preservation of hearing by surgery of bilateral vestibular schwannoma which occur in more than 90% of the NF2-patients.

摘要

背景

2型神经纤维瘤病(NF2)是一种常染色体显性遗传性疾病,可导致中枢和周围神经系统肿瘤生长。在成年患者中,常伴有眼部异常,如青少年白内障。

方法

对10名年龄在1至14岁疑似患有NF2的儿童进行了眼科检查。通过进一步的临床检查确诊,其中1例通过系谱分析确诊。

结果

这10名儿童中有9名表现出眼部异常,如青少年后囊下白内障、视网膜错构瘤、视神经鞘瘤、纤维化黄斑病变,还有1例视神经周围钙化以及1例第三脑室旁脑错构瘤。

讨论

在6名儿童中,眼部症状是该疾病的首发症状。了解这些症状有助于对出现孤立性眼部缺陷或其他典型疾病标准的儿童进行NF2的诊断。对于超过90%的NF2患者出现的双侧前庭神经鞘瘤,通过手术保留听力,该疾病的早期诊断可能会改善预后。

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