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.
甲状腺相关眼病(thyroid-associated ophthalmopathy,TAO)，又称Graves眼病，是与甲状腺疾病密切相关的一种器官特异性自身免疫性疾病。眼球突出是TAO的主要临床表现之一，也是临床上多数患者就诊的原因。眼球突出一方面会影响美观，另一方面可因眼睑闭合不全导致暴露性角膜炎或因眼眶压力增大导致压迫性视神经病变。眼眶减压术用于重度TAO已有过百年历史，从最早经外眦皮肤切开的传统外部切口入路进行骨性眼眶减压及脂肪减压到内镜下经鼻入路眼眶减压术，其安全性和有效性均已得到肯定。术后复视是眼眶减压术常见的并发症。近年来，随着眼眶减压术的发展，其越来越多地用于美容目的以矫正眼球突出。然而术后的新发复视仍然是困扰众多相关眼科医疗工作者的难题。近年来，多项研究对术后新发复视的相关因素进行了探讨，并由此对眼眶减压术进行改良，在对术后新发复视的减少方面取得不同程度的进展。该文对眼眶减压术后新发复视的研究进展进行综述，旨在促进专科医生更精准地开展TAO的手术，进而提高手术患者术后的生活质量及手术满意度。
Thyroid-associated ophthalmopathy (TAO), known as Graves’orbitopathy, is an organ specific autoimmune disease closely related to thyroid diseases. Exophthalmos is one of the main clinical manifestations of thyroid related ophthalmopathy and is also the reason for most patients seeking medical atention in clinical practice.Eyeball protrusion can afect aesthetics on the one hand, and on the other hand, it can lead to exposed keratitis due to incomplete closure of the eyelids or compressive optic neuropathy due to increased orbital pressure.Orbital decompression has been used to treat severe TAO that threatens vision for over 100 years, and its safety and efectiveness have been confrmed.However, postoperative new diplopia remains a challenge for many ophthalmic medical workers.In recent years, many studies have explored the relevant factors of postoperative new diplopia, and improved the surgery, achieving varying degrees of progress in reducing postoperative new diplopia.Tis article reviews the research progress of new diplopia afer orbital decompression, aiming to promote more accurate surgery for thyroid related eye diseases by specialized doctors.
