渐进性视功能障碍多见于屈光不正、原发性开角型青光眼、白内障、视神经视网膜遗传代谢性疾病等，少见于眶内和颅内占位性疾病。颅内蛛网膜囊肿通常是无症状的先天性良性病变，少数出现视功能障碍。 视神经管骨壁缺如见于后组筛窦和蝶窦气化良好的正常人。该文报告 1例59岁男性患者，因左眼视野缺损伴视物模糊1年余就诊，确诊左侧颞极蛛网膜囊肿合并视神经管骨壁缺如。笔者通过收集该患者的病史、影像学资料和视功能检查结果，分析其出现视功能障碍的机制。

Progressive visual impairment is more common in ametropia, primary open-angle glaucoma, cataract, hereditary and metabolic diseases of optic nerve and retina, and less common in orbital and intracranial masses. Intracranial arachnoid cysts are usually asymptomatic benign congenital lesions with a small number of visual impairments. The absence of the bone wall of the optic canal was seen in normal subjects with good gasification of the posterior ethmoid sinus and sphenoid sinus. In this case report we describe a 59-year-old man with a left temporal arachnoid cyst and a defect of the bone wall of the optic canal complained of left visual field defect and blurred vision for more than one year. The mechanism of visual dysfunction was analyzed by collecting the patient’s medical history, imaging data and the results of visual function examination.

目的: 测量单眼挫伤患者瞳孔对光反射的改变, 分析瞳孔对光反射与眼挫伤后其他视功能评价方法的相关性。

方法: 使用红外线自动瞳孔仪分别检测 26 例单眼挫伤患者双眼瞳孔对光反射, 并行视力、视野、图形视觉诱发电位等视功能检查。检查的瞳孔对光反射参数包括瞳孔面积, 对光反应潜伏期、反应幅度。

结果: 眼挫伤患者健眼直接、间接反应幅度比与双眼视力差具有显著相关性(r =- 0.648) ; 瞳孔对光反应幅度差、反应幅度比均与视野平均偏差具有显著相关性(r =0.5 和 r =- 0.535) ; 瞳孔对光反应幅度比与双眼视觉诱发电位振幅比具有显著相关性; 多重线性回归分析显示瞳孔对光反应幅度和 VEP 振幅结合可提高预测视力预后的可能性。

结论: 在瞳孔对光反射各参数中, 瞳孔对光反应幅度在反映眼挫伤后视功能改变方面优于其它参数, 眼挫伤患者瞳孔对光反应幅度与视力、视野、VEP 波幅具有中度相关性, 其与 VEP 联合应用可提高眼挫伤后准确预测视功能的可能性。

Subjects and objective: To measure the quantitative pupil light reflex after unilateral ocular contusion, analyze the correlation of pupil light reflex and other tests of visual function.

Methods: The pupil light reflex in 26 patients who suffered unilateral ocular contusion was tested by infrared video pupillography, psychophysical and electrophysiological tests including visual acuity, visual field, and visual evoked potentials were also tested. Pupil area, the latency and amplitude of pupil light reflex were recorded.

Results: The correlation of the ratio of pupil light reflex amplitude and the differences of visual acuity between 2 eyes in 26 contusion patients was statistically significant. The correlation coefficient r was - 0.648. There were significant correlation between amplitude of pupil light reflex and median defect of visual field. The correlation coefficients r were 0.5 and 0.535. The significant correlations were found in the ratio of amplitudes between pupil light reflex and visual evoked potentials. Multiple linear regression analysis showed combining pupil light reflex amplitude and visual evoked potential amplitude could elevate the possibility of predicting visual acuity.

Conclusion: Pupil light reflex amplitude measurement is superior to other pupil measurements for reflection of the changes of visual function after ocular contusion. The correlations of pupil light reflex amplitude and visual acuity, visual field, visual evoked potential are significant in the ocular contusion patient. Pupil light reflex combined with visual evoked potential could elevate the possibility of predicting visual function precisely after ocular contusion.

目的:探讨垂体腺瘤对眼视功能损害的临床表现。

方法:对 126 例( 252 只眼)垂体腺瘤患者进行视力、视野、荧光眼底血管造影(Fundus fuorescein angiography, FFA)、图形视诱发电位(Pattem visual evoked potential, PVEP)及眼底检査。

结果:视力下降 186 只眼,占73.8%。眼底原发性视神经萎缩 130 只眼,占51.6%。视野缺损 156 只眼,占69.6%。PVEP异常 160 只眼,占88.9%。26.2%的患者以眼部异常为首诊症状,其中16.7%曾被诊断为眼科疾病。

结论:垂体腺瘤可引起视功能的损害,充分认识垂体腺瘤在眼部的临床特点,有助于早期诊断及时治疗。

Purpose : To investigate the clinical manifestation of damage of visual function causedby pituitary adenoma.

Methods: Visual acuity, visual field, fundus fluorescein angiography (FFA), pattemvisual evoked potential (PVEP) and examination fundus were performed in 126 cases(252 eyes)of pituitary tumor.

Results :There was 73.8% (186 eyes) of patients with decreased visual acuity, 51.6%(130 eyes) with primary optic atrophy, 69.6 %(156 eyes) with the defects of visualfield and 88.9%(160 eyes) with abnormal PVEP. Abnormal ophalmological manifestationwas the first diagnostic symptom in 26.2%, and 16.7% was misdiagnosed as eye diseases.

Conclusions: Pituitary tumor could cause defection of visual function. lt is helpful toearly diagnosis and timely treatment by fully understanding clinical features in the eyewith pituitary tumor.