Focal electroretinogram and visual field defect in multiple evanescent white dot syndrome.
Focal electroretinogram and visual field defect in multiple evanescent white dot syndrome.
复制标题
多发性消失白点综合征的局灶视网膜电图和视野缺损。
DOI：
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发表时间：
1993
影响因子：
4.1
通讯作者：
Yukari Fujii
中科院分区：
文献类型：
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作者：
M. Horiguchi;Y. Miyake;M. Nakamura;Yukari Fujii
脉络膜炎和较少发生的视乳头炎或视神经炎。我们的病人同时出现两个脉络膜视网膜炎的复发，这是弓形虫病的特征，可能与视力丧失和视野缺损有关。然而，疼痛的眼球运动和传入性瞳孔缺损更提示视神经疾病。78这一点得到了MRI检查的证实，MRI检查显示右侧视神经中部有活动性炎症病变，与视网膜病变分开。这种视神经损害发生在脱髓鞘疾病、肉芽肿疾病和Leber遗传性视神经病变中，后者通常位于更靠后的位置。然而，视神经病变更可能是由活动性弓形虫病变引起的，特别是当没有其他脱髓鞘特征时。在一名患有先天性弓形虫病的婴儿、一名长期接受类固醇治疗的患者4和两名艾滋病患者23死后，从视神经中分离出弓形虫。“本报告是独特的，在描述一个免疫功能正常的成年人，除了活跃的视网膜弓形虫病，同时有一个活跃的球后视神经病变的MRI。这是第一个关于这种关联的体内报告，提出了在典型的弓形体视网膜脉络膜炎病例中视神经病变可能比以前认为的更常见的可能性，并且如果视觉功能与临床表现或视网膜病变的地形图无关，MRI可能是有价值的。
choroiditis and less frequently papillitis or optic neuritis. Our patient presented with simultaneous reactivation of two areas of choroidoretinitis, characteristic of toxoplasmosis, which could be related to the loss of visual acuity and the visual field defect. However, the painful eye movements and the afferent pupillary defect were more suggestive of optic nerve disease.78 This was confirmed by an MRI examination which revealed an active inflamatory lesion in mid-portion of the right optic nerve, separate from the retinal lesions. Such optic nerve lesions occur in demyelinating disease,59 in granulomatous disease and in Leber's hereditary optic neuropathy,"' which is usually situated more posteriorly. However, the optic nerve lesion is more likely to have resulted from an active toxoplasmic lesion, particularly as there were no other features of demyelination. Toxoplasma gondii has been isolated from the optic nerves at post morten in an infant with congenital toxoplasmosis,' a patient receiving long term steroids,4 and in two patients with AIDS.23 Rarely, the cysts are associated with inflammation and demyelination of the optic nerve." The present report is unique in describing an immunocompetent adult who, in addition to active retinal toxoplasmosis, had a simultaneously active retrobulbar optic nerve lesion on MRI. This is the first in vivo report ofsuch an association, raisig the possibility that optic nerve lesions may be more common in cases of typical toxoplasmic retinochoroiditis than previously considered, and that MRI may be valuable ifvisual function does not correlate with the clinical presentation or with the topography of the retinal lesions.