急性特发性生理盲点扩大综合征一例

A Case Report of Acute Idiopathic Blind Spot Enlargement Syndrome

摘要: 69岁男性患者，左眼突然视物发雾、变暗、阅读困难，伴闪光感6天，加重1天，否认糖尿病、高血压病。右眼视力HM，视乳头色白，血管变细。左眼视力0.04，最佳矫正视力0.25。眼底近视改变，RAPD(+)，色觉异常，ERG，mfERG异常，OCT示双眼视网膜外界膜、IS/OS层缺失。视野检查示左眼生理盲点明显扩大。FFA未见明显异常。治疗4月后，左眼视力0.2，最佳矫正视力0.5。各种症状好转，可以正常阅读工作。RAPD(−)，色觉仍异常。诊断：急性特发性生理盲点扩大综合征(AIBSE)。AIBSE是一种较少见的外层视网膜病变。

Abstract: A 69-year-old male patient complained of a sudden visual loss and reading difficulties, combined with photopsia for 6 days, worse 1 day. Diabetes or hypertension was negative. The visual acuity of right eye was hand motion. The papillary of right eye was pale and the vessels of fundus were attenuated. The visual acuity of left eye was 0.04, and the best corrected visual acuity was 0.25. The myopic fundus was seen, RAPD (+), color anomaly, ERG and mfERG abnormalities were found. The OCT revealed the abnormalities of the IS/OS line and external limiting membrane in both eyes. Visual field detected blind spot extension in left eye. FFA showed minimal abnormalities. 4 months later, the visual acuity of left eye was improved to 0.2, and the best corrected visual acuity was 0.5. Various symptoms improved, and reading difficulties were gone. RAPD (−), color vision was still abnormal. The diagnosis of the patient is acute idiopathic blind spot enlargement syndrome (AIBSE). AIBSE is a rare outer retinopathy.