小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 视力下降家族史
- 维生素 A（视黄醇）缺乏症或恶性肿瘤的既往病史
其他诊断因素
- 弱光下视力下降
- 瞳孔反应各不相同（取决于潜在的病因）
- 视网膜血管变细
- 视野缺损
- 周边脉络膜视网膜变性
- 干扰维生素 A（视黄醇）代谢的用药史
危险因素
- 视网膜色素变性
- 先天性静止性夜盲
- 维生素 A（视黄醇）缺乏症
- 癌症相关性视网膜病变
- 黑色素瘤相关性视网膜病变
- 回旋状萎缩
- 无脉络膜症
诊断性检查
首要检查
- 视网膜电图 (ERG)
- 裂隙灯活体显微镜检查和间接检眼镜检查
需考虑的检查
- 血清维生素 A（视黄醇）水平
- 下一代测序
治疗流程
遗传性夜盲症
获得性夜盲症
撰稿人
作者
Jonathan Smith, FRCOphth, MRCP
Consultant Ophthalmologist
Sunderland Eye Infirmary
Sunderland
UK
利益声明
JS has received sponsorship from Novartis, Bayer, and DORC for meeting travel and accommodation. JS was awarded a research grant in 2017 by the British Vitreoretinal Society.
Muhammad Raza Cheema, MRCGP, MRes, FRCOphth, FEBO
Specialist Registrar
Ophthalmology
Sunderland Eye Infirmary
Sunderland
UK
利益声明
MRC declares that he has no competing interests.
Wendy Adams, MRCP, FRCOphth
Consultant Ophthalmologist
Sunderland Eye Infirmary
Sunderland
UK
利益声明
WA declares that she has no competing interests.
鸣谢
Dr Jonathan Smith, Dr Wendy Adams, and Dr Muhammad Raza Cheema would like to gratefully acknowledge the assistance of Ms Karen Bradshaw. KB declares that she has no competing interests.
同行评议者
Makoto Nakamura, MD
Associate Professor
Department of Ophthalmology
Nagoya University Graduate School of Medicine
Nagoya
Japan
利益声明
MN declares that he has no competing interests.
Eric Amesbury, MD
Klara Spinks Fleming Fellow
Jules Stein Eye Institute
UCLA
Los Angeles
CA
利益声明
EA declares that he has no competing interests.
Creig S. Hoyt, MD
Emeritus Professor and Chairman
Department of Ophthalmology
University of California
San Francisco
CA
利益声明
CSH declares that he has no competing interests.
鉴别诊断
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- 青光眼
- 视神经病变
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