眼科 ›› 2012, Vol. 21 ›› Issue (5): 309-312.

• 论著 • 上一篇    下一篇

空蝶鞍综合征眼部特征分析

 王洪涛, 李树宁,  王宁利,  杨本涛   

  1. 100730 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室(王洪涛、李树宁、王宁利);放射科(杨本涛)
  • 收稿日期:2012-07-17 出版日期:2012-09-25 发布日期:2012-09-28
  • 通讯作者: 王宁利,Email: wningli@vip.163.com

The ocular appearance of empty sella syndrome

 WANG  Hong-Tao, LI  Shu-Ning,   Wang-Ning-Li,   Yang-Ben-Tao   

  1. Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmol and Vis Sci Key Lab., Beijing 100730, China
  • Received:2012-07-17 Online:2012-09-25 Published:2012-09-28
  • Contact: WANG Ning-li, Email: Wningli@vip.163.com

摘要: 目的  探讨空蝶鞍综合征的眼部临床表现及预后。设计 回顾性病例系列。研究对象 在北京同仁医院就诊,经MRI检查诊断为空蝶鞍综合征的32例患者。方法  对这些患者的检查治疗资料及眼部表现进行分析。主要指标 视力、眼压、眼底、视野、房角。结果 32例患者中因明显视力下降就诊者20例(62.5%)。最佳矫正视力低于0.8者45眼,其中低于0.1者5眼,0.1~0.3者14眼,0.4~0.7者26眼。眼压在21~29 mm Hg者13眼(20.3%)。眼底检查13眼(20.3%)有视盘水肿,19眼(29.7%)有视神经萎缩。视野缺损48眼(75.0%),其中9眼有类似青光眼的视野缺损,10例患者为双颞侧偏盲。房角开放者28例56眼(87.5%),房角窄或可疑关闭者4例8眼(12.5%)。3例空蝶鞍综合征患者合并闭角型青光眼,1例合并开角型青光眼,2例合并正常眼压性青光眼。3例患者经神经外科手术治疗,最佳矫正视力好转。结论 空蝶鞍综合征的眼部表现可有视力下降、视盘水肿、视神经萎缩及视野缺损。对于不能由眼科疾病解释而怀疑本病者,应及时请相关科室会诊并协助治疗。(眼科, 2012, 21: 309-312)

关键词: 空蝶鞍综合征, 眼部表现

Abstract: Objective To analyze the ocular appearance of primary empty sella syndrome (ESS) patients. Design Retrospective case series. Participants 32 patients diagnosed as empty sella and partial empty sella after brain MRI examination in Beijing Tongren Hospital. Methods All patients underwent ocular examination, and the ocular characteristics of patients were analyzed.  Main Outcome Measures Visual acuity, intraocular pressure(IOP), fundus, visual fields,  angle of anterior chamber. Results In the 32 patients,  a chief complaint of blurred vision happened in 20 cases. The best corrected visual acurity (BCVA) was less than 0.8 in 45 eyes, and among these 45 eyes, BCVA less than 0.1 in 5 eyes, 0.1~0.3 in 14 eyes, 0.4~0.7 in 26 eyes. In 13 eyes(20.3%), the IOP varied from 21 to 29 mm Hg. Papillary edema was found in 13 eyes(20.3%). Optic nerve atrophy was found in 19 eyes(29.7%). Among the 48 eyes(75.0%)which had visual field defect, 9 eyes had similar visual field defect with glaucoma. Bitemporal hemianopia was found in 10 cases. 28 cases had wide or open angle. 4 cases had narrow or closed angle. We found ESS combined with primary angle closed glaucoma in 3 cases, with primary open angle glaucoma in 1 cases, with normal tension glaucoma in 2 cases. BCVA of 3 ESS patients progressed after operation of neurosurgery.  Conclusions The findings indicate the ocular appearance of empty sella syndrome could be decreased visual acuity, optic disc edema, optic nerve atrophy, and visual field defect.  If the clinical appearance could not be explained by eye disease and suspected the ESS, we should discuss with neurologist for denifite diagnosis and treatment.(Ophthalmol CHN, 2012, 21: 309-312)

Key words: empty sella syndrome, ocular appearance