Erb C, Preyer S, Thiel H J
Universitäts-Augenklinik, Tübingen.
Ophthalmologe. 1996 Aug;93(4):433-9.
The etiology of sudden hearing loss is still not known. Among other pathomechanisms, vascular disorders have been proposed as an underlying cause. We investigated patients with sudden hearing loss for signs of microcirculation disorders.
Thirty-one patients (15 males and 16 females, mean age 37.5 years) were admitted because of sudden hearing loss. In addition, all patients underwent thorough ophthalmologic examination.
Refraction, vision, intraocular pressure and excavation of the optic nerve were normal. In 81% of all cases abnormal conjunctival vascular ectasia were detected. The fundus of 53% of the patients was characterized by slight tortuosity of arterial retinal vessels. The first 11 patients received an ocular electrophysiological examination and showed normal ERG, P-VEP and dark adaptation. Standard perimetry (TAP 2000 ct) revealed no abnormalities in 29 patients, 2 glaucoma patients had small arcuate scotomas. However, 90% of all 29 scotoma-free patients were abnormal in the white-noise campimetry (TEC, Oculus). Testing for color vision (Roth 28 HUE, desat.) revealed abnormally high values (right 120, left 131).
Although patients with sudden hearing loss appeared healthy in the standard eye examination, the more sensitive tests of white-noise campimetry and color vision, together with the conjunctival vascular ectasia and the tortuosity of arterial retinal vessels, indicated a disturbed microcirculation.
突发性听力损失的病因仍不清楚。在其他病理机制中,血管紊乱被认为是潜在病因。我们对突发性听力损失患者进行了微循环障碍迹象的调查。
31例患者(15名男性和16名女性,平均年龄37.5岁)因突发性听力损失入院。此外,所有患者均接受了全面的眼科检查。
屈光、视力、眼压和视神经盘凹陷均正常。在所有病例中,81%检测到结膜血管扩张异常。53%的患者眼底表现为视网膜动脉血管轻度迂曲。前11例患者接受了眼电生理检查,结果显示视网膜电图(ERG)、图形视觉诱发电位(P-VEP)和暗适应正常。标准视野检查(TAP 2000 ct)显示,29例患者无异常,2例青光眼患者有小的弓形暗点。然而,在29例无暗点的患者中,90%在白噪声视野检查(TEC,奥culus)中异常。色觉测试(Roth 28 HUE,去饱和)显示异常高值(右眼120,左眼131)。
尽管突发性听力损失患者在标准眼科检查中看似健康,但白噪声视野检查和色觉的更敏感测试,以及结膜血管扩张和视网膜动脉血管迂曲,表明存在微循环障碍。