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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Influence of Optic Nerve Appearance on Visual Outcome in Pediatric Idiopathic Intracranial Hypertension
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Influence of Optic Nerve Appearance on Visual Outcome in Pediatric Idiopathic Intracranial Hypertension

机译：视神经外观对小儿特发性颅内高血压视觉结果的影响

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Objectives: To determine whether optic disc hemorrhages (ODH) and cotton wool spots (CWS) at presentation are associated with worse visual outcomes in pediatric patients with idiopathic intracranial hypertension (IIH). Methods: Retrospective institutional review of 100 eyes of 50 consecutive pediatric IIH patients (aged 16 years or less) who had baseline optic disc photographs before or within 30 days of their diagnostic lumbar puncture and initiation of medical treatment. Optic disc photographs were independently graded by three ophthalmologists in a standardized manner. Visual function was assessed using visual acuity (VA) and visual field grade (VFG). Results: At least one ODH was found in 41% of eyes, at least one CWS was found in 27% of eyes, and 20% of eyes had both ODH and CWS. At presentation, Frisén grade was associated with the presence of CWS (p = 0.013) and showed no association with ODH (p = 0.060). When controlling for Frisén grade, ODH and CWS were not associated with worse VA or VFG at final follow-up. Severe ODH were associated with worse VA and VFG at presentation (p < 0.03), but not at final follow-up. Severe CWS at presentation was strongly associated with a worse Humphrey mean deviation of 5.0 dB (95% confidence interval 1.6-8.3) at final follow-up (p = 0.002). Conclusion: When controlling for the severity of papilledema, ODH do not provide any additional prognostic value in pediatric IIH patients. Frisén grade and severe CWS at presentation were independently associated with worse visual outcomes at the final follow-up.
机译：目的：确定儿童特发性颅内高压（IIH）患者出现视盘出血（ODH）和棉絮斑（CWS）时是否与视力不良相关。方法：对50例连续的儿童IIH患者（年龄16岁或以下）的100只眼进行回顾性机构审查，这些患者在诊断性腰椎穿刺和开始治疗前或30天内接受了基线视盘照片。视盘照片由三名眼科医生以标准化的方式进行独立分级。用视力（VA）和视野分级（VFG）评估视功能。结果：41%的眼睛至少有一个ODH，27%的眼睛至少有一个CWS，20%的眼睛同时有ODH和CWS。在演示时，Frisén评分与CWS的存在相关（p=0.013），与ODH无关（p=0.060）。在控制Frisén分级时，ODH和CWS与最终随访时VA或VFG的恶化无关。重度ODH患者在出现时的VA和VFG更差（p<0.03），但在最终随访时没有。在最后的随访中（p=0.002），出现严重CWS时的汉弗莱平均偏差为5.0 dB（95%置信区间1.6-8.3），与严重CWS密切相关。结论：当控制乳头水肿的严重程度时，ODH不能为儿童IIH患者提供任何额外的预后价值。在最后的随访中，Frisén分级和严重CWS与较差的视力结果独立相关。

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