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ENGLISH ABSTRACT
神经眼科急症的诊断和治疗
董莹
魏世辉 [综述]
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20201104-00737
Diagnosis and therapy of neuro-ophthalmological emergencies
Dong Ying
Wei Shihui
Authors Info & Affiliations
Dong Ying
Department of Ophthalmology, The Fourth Medical Center of PLA General Hospital, Beijing 100048, China
Wei Shihui
Department of Ophthalmology, The Fourth Medical Center of PLA General Hospital, Beijing 100048, China
·
DOI： 10.3760/cma.j.cn115989-20201104-00737
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摘要

神经眼科急症是指如果不及时诊治，就会严重威胁视力或生命的眼科临床病症，主要表现为急性视力下降、突发的复视和瞳孔不等大。一些危重神经系统疾病和眶颅炎症早期常以神经眼科急症作为首发表现。视神经炎、动脉炎性前部缺血性视神经病变、严重的眼眶炎症和感染、垂体卒中等疾病早期常出现急性视力下降；海绵窦血栓和颅内动脉瘤早期因累及颅神经而出现复视；此外，颅内动脉瘤和颈动脉夹层动脉瘤在发病初期可表现为双眼瞳孔不等大。本文从急救医学角度对上述相关疾病的症状、体征、诊断和治疗进行阐述，分析神经眼科体征在疾病诊断中的重要作用，旨在提高眼科医生对神经眼科急症的识别能力，加强危重症的防范意识。

神经眼科;急救医学;复视;颅神经麻痹;瞳孔不等大
ABSTRACT

Neuro-ophthalmological emergencies are some ocular manifestations, which are associated with the sight or life-threatening diseases if not promptly treated, including acute visual loss, sudden diplopia or anisocoria.Some severe nerve system or orbitocranial inflammatory diseases frequently present neuro-ophthalmological symptoms at the early stage.Acute visual loss is the common complaint of optic neuritis, arteritic anterior ischemic optic neuropathy, rhino-orbital-cerebral mucormycosis, and pituitary apoplexy.Diplopia usually occurs in cavernous sinus thrombosis or intracranial aneurysm because of cranial nerve palsies.Additionally, intracranial aneurysms and carotid artery dissecting aneurysm often present anisocoria initially.The clinical symptoms, signs, diagnosis and management of these disorders were reviewed from the point of emergency medicine, and the role of neuro-ophthalmological signs in the diagnosis was highlighted in this review, aiming to help ophthalmologists improve the awareness of these conditions, and emphasize the urgency of these signs.

Neuro-ophthalmology;Emergency medicine;Diplopia;Cranial nerve palsy;Anisocoria
Wei Shihui, Email: mocdef.labiamtoh607iuhihsiew
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引用本文

董莹,魏世辉. 神经眼科急症的诊断和治疗[J]. 中华实验眼科杂志,2021,39(03)：254-258.

DOI:10.3760/cma.j.cn115989-20201104-00737

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神经眼科急症是指如果不及时诊治，就会严重威胁患者视力或生命的眼科临床病症 [ 1 ]。神经眼科急症多表现为急性视力下降、突发的复视和瞳孔不等大。有些神经眼科急症，即使及时治疗，致死率也很高。一些危重神经系统疾病和眶颅炎症早期常以神经眼科急症作为首发表现，因此神经眼科急症在这些疾病的诊断中具有重要的提示意义。然而，神经眼科处于眼科、神经科、耳鼻喉科、急诊等学科的交叉领域，并不为广大眼科或急诊科医生所熟知。本文从急救医学角度对神经眼科急症进行阐述，旨在提高眼科医生对其识别能力，加强急危重症疾病的早期诊治。
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备注信息
A
魏世辉，Email： mocdef.labiamtoh607iuhihsiew
B
所有作者均声明不存在利益冲突
C
国家自然科学基金项目 (31300814)
解放军总医院第一附属医院科技创新基金项目 (2016FC-304Z-TSYS-02)
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