中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2012年
11期
698-699
,共2页
王静波%谢应勤%王慧霞%张桥%关娟%余欢龙
王靜波%謝應勤%王慧霞%張橋%關娟%餘歡龍
왕정파%사응근%왕혜하%장교%관연%여환룡
重症肌无力%眼%肌肉
重癥肌無力%眼%肌肉
중증기무력%안%기육
Myasthenia gravis%Ocular%Muscle
目的 总结并分析我院重症肌无力(MG)患者的眼部情况.方法 回顾性病例研究.对2009年1月至2011年8月来我科会诊的181例MG患者行眼科检查,包括视力、裂隙灯显微镜检查、眼底、屈光状态、33 cm及6 m眼位、眼球运动、红玻片法检查复视像,部分患者行同视机检查.对数据进行分类、整理和归纳.结果 181例中,眼肌型MG占多数(86例,47.5％)；眼位正常者150例(82.9％)；上睑下垂175例(96.7％)；单眼弱视5例(2.8％)；复视156例(86.2％).单条眼外肌麻痹55例(30.4％),多条眼外肌麻痹77例(42.5％),全眼外肌麻痹13例(7.2％).55例单条眼外肌麻痹患者中,内直肌受累最多(14例,25.5％).结论 MG患者中眼肌型占了近半数,绝大多数均有上睑下垂和复视,但绝大多数患者的眼位都是正常的.部分患者因发病较早,上睑下垂造成了形觉剥夺性弱视.MG患者的眼外肌麻痹可为单条、多条或全眼外肌麻痹,其中多条和单条眼外肌麻痹多见.在单条眼外肌麻痹的患者中,内直肌受累更多见.
目的 總結併分析我院重癥肌無力(MG)患者的眼部情況.方法 迴顧性病例研究.對2009年1月至2011年8月來我科會診的181例MG患者行眼科檢查,包括視力、裂隙燈顯微鏡檢查、眼底、屈光狀態、33 cm及6 m眼位、眼毬運動、紅玻片法檢查複視像,部分患者行同視機檢查.對數據進行分類、整理和歸納.結果 181例中,眼肌型MG佔多數(86例,47.5％)；眼位正常者150例(82.9％)；上瞼下垂175例(96.7％)；單眼弱視5例(2.8％)；複視156例(86.2％).單條眼外肌痳痺55例(30.4％),多條眼外肌痳痺77例(42.5％),全眼外肌痳痺13例(7.2％).55例單條眼外肌痳痺患者中,內直肌受纍最多(14例,25.5％).結論 MG患者中眼肌型佔瞭近半數,絕大多數均有上瞼下垂和複視,但絕大多數患者的眼位都是正常的.部分患者因髮病較早,上瞼下垂造成瞭形覺剝奪性弱視.MG患者的眼外肌痳痺可為單條、多條或全眼外肌痳痺,其中多條和單條眼外肌痳痺多見.在單條眼外肌痳痺的患者中,內直肌受纍更多見.
목적 총결병분석아원중증기무력(MG)환자적안부정황.방법 회고성병례연구.대2009년1월지2011년8월래아과회진적181례MG환자행안과검사,포괄시력、렬극등현미경검사、안저、굴광상태、33 cm급6 m안위、안구운동、홍파편법검사복시상,부분환자행동시궤검사.대수거진행분류、정리화귀납.결과 181례중,안기형MG점다수(86례,47.5％)；안위정상자150례(82.9％)；상검하수175례(96.7％)；단안약시5례(2.8％)；복시156례(86.2％).단조안외기마비55례(30.4％),다조안외기마비77례(42.5％),전안외기마비13례(7.2％).55례단조안외기마비환자중,내직기수루최다(14례,25.5％).결론 MG환자중안기형점료근반수,절대다수균유상검하수화복시,단절대다수환자적안위도시정상적.부분환자인발병교조,상검하수조성료형각박탈성약시.MG환자적안외기마비가위단조、다조혹전안외기마비,기중다조화단조안외기마비다견.재단조안외기마비적환자중,내직기수루경다견.
Objective To summarize and analyze the ocular conditions of patients with myasthenia gravis (MG) diagnosed in the MG therapy center and those who came for ocular consultation in our department.Methods In a retrospective case study,181 patients with MG who came for ocular consultation from January 2009 to August 2011 were analyzed,and underwent the following examinations:visual acuity,slit lamp microscope examination,fundus examination,refractive condition,eye alignment at 33 cm and 6 m,eye movement,and diplopic images by the red glass test.Some patients were also examined with a synoptophore.Data was categorized,collected and analyzed.Results Of those 181 cases,many patients were diagnosed with ocular MG (86,47.5％),150 cases had normal eye alignment (82.9％),175 cases had eyelid ptosis (96.7％),5 cases had monocular amblyopia (2.8％),and 156 patients had diplopia (86.2％).Of those 181 cases,55 patients (30.4％) had paralysis of one simple ocular muscle,77 cases (42.5％) had paralysis of multiple ocular muscles,and 13 patients (7.2％) had paralysis of all ocular muscles.Of those 55 patients with paralysis of one simple ocular muscle,most had involvement of the medial rectus (14,25.5％).Conclusion Almost half of the former patients with MG who came for ocular consultation were diagnosed with ocular MG.In patients with MG,most had eyelid ptosis and diplopia.However,most patients had normal eye alignment.The patients who developed MG early had form deprivation amblyopia because of eyelid ptosis.Paralysis of ocular muscles can involve one simple muscle,multiple muscles or all muscles,and most patients had a paralysis of multiple muscles or one simple muscle.In patients with paralysis of one simple ocular muscle,the medial rectus muscle was most often involved.
