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目的:分析误诊为其他疾病的埋藏性视乳头玻璃膜疣的原因和临床特点。方法:回顾性分析8例(10眼)误诊为视乳头水肿和缺血性视神经病变的埋藏性视乳头玻璃膜疣患者的一般情况及视力、眼底、视野、视觉诱发电位、眼底荧光血管造影、眼部B超和头颅CT检查情况等资料。结果:就诊时的视力:0.1-1.0。眼底检查显示所有病例均表现视乳头水肿,边界不清,部分病例可有视乳头或其边缘出血。8例患者中,6例视野正常,2例表现为生理盲点扩大及与视乳头相连的弓形暗点;眼底荧光血管造影均显示视盘部分荧光逐渐增强,后期呈斑块状、结节样或不均匀强荧光,持续时间长,其形态、大小无变化,无荧光素渗漏。视觉诱发电位未见明显异常。B超检查可见视乳头隆起,有结节样强回声。结论:埋藏性视乳头玻璃膜疣临床上较少见,常被误诊为视乳头水肿和缺血性视神经病变,眼底荧光血管造影及眼部B超检查具有诊断意义。
Objective: To analyze the causes and clinical features of buried optic papilla caused by misdiagnosis of other diseases. Methods: A retrospective analysis of 8 cases (10 eyes) misdiagnosed as optic disc edema and ischemic optic neuropathy buried papilla in patients with general conditions and visual acuity, fundus, visual field, visual evoked potential, fundus fluorescein angiography, Eye B ultrasound and CT examination and other information. Results: Visibility at the time of visit: 0.1-1.0. Fundus examination showed that all cases showed papilledema, the boundary is unclear, in some cases may have papillae or edge bleeding. Of the 8 patients, 6 had a normal field of vision and 2 showed enlarged physiological blind spots and arcuate dark spots connected to the optic disc. Fundus fluorescein angiography showed that the fluorescence of the optic disc gradually increased and showed plaque, nodules or no Even strong fluorescence, long duration, no change in shape, size, no fluorescein leakage. Visual evoked potential no obvious abnormalities. B-ultrasound showed papillae uplift, nodular-like echo. CONCLUSION: Buried optic disc drusen is rare in clinic and is often misdiagnosed as papilledema and ischemic optic neuropathy. Fluorescent angiography and ocular B-ultrasound are of diagnostic significance.