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愛盲服務 -低視能服務 -常見低視能疾病 - 視神經萎縮 Optic Nerve Atrophy -財團法人愛盲基金會
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其視野缺損表現也為病灶對側同側偏盲,但雙眼損害多較對稱,且由於與視覺纖維伴行的瞳孔纖維在視覺纖維進入外側膝狀體之前已經離開視束,因而不伴有Wernicke偏盲性瞳孔強直。 外側膝狀體病變後期也可引起原發性視神經萎縮。 在停藥數月後視力開始恢復,6個月~一年恢復正常。 有部分患者停藥後視力可繼續下降,經數月再恢復。 眼底可恢復正常,也可遺留不同程度的視神經萎縮。

視野檢查多表現為生理盲點擴大,有時可出現中心暗點或小片視野缺損。 眼底螢光血管造影顯示視盤及視網膜靜脈螢光滲漏,靜脈充盈延遲。 Leber氏遺傳性視神經病變是因視神經細胞凋亡導致視力衰退的遺傳性疾病,大部分患者在青壯年時期發病,少數患者發病時間可能較早或較晚。 目前臨床上發現男性發病的比例較女性為高,原因不明。 初期症狀為視力模糊、渾濁,可能單眼先發病,或雙眼同時發病;如果一眼視力已開始衰退,另一眼視力也會在數週或數個月內受損。 發病時間愈長,雙眼視覺會逐漸惡化,視力及辨色力會嚴重變差,病症主要影響需清晰、細緻判斷的中央視力 ,使患者無法順利閱讀、駕駛及辨視人臉。 視野向心性縮小,有時可呈管狀視野,但無中心暗點。

3痢特靈中毒痢特靈為治療腸道感染後腹瀉及菌痢的藥物。 在小劑量服用後,可產生視神經損傷,且預後較差。 一般在服藥後數小時至數天可出現雙眼視力不同程度的減退,甚至黑,伴有眼痛、色覺障礙。

視束本身的病變較為少見,常系鄰近組織的腫瘤、血管病變或脫髓鞘性疾病所引起。 視束受損時,表現為病變對側的雙眼同側偏盲,例如左側視束病變引起左側鼻側視野、右眼顳側視野缺損。 外燴 但由於視束中的交叉和不交叉的視覺纖維在視束中各占一定的部位,互不摻雜,因此,雙眼視野改變可不一致。

詹立瑋醫師說明,視神經病變可能是漸進式變化,且病變時間可長達數月之久,導致患者不易察覺視力缺損,更可能錯過有效治療期;而當視神經病變時間越久,可能造成神經纖維損傷及不可逆的視力損害,嚴重恐演變成失明。 當視神經從眼球最末端進入腦部前,因外傷或疾病出現視力下降、辨色力異常、對光反射遲緩等症狀時,即稱為「視神經病變」。 吸煙可導致許多種疾病,國內外關於煙草所導致的中毒性視神經病變(也稱煙中毒性弱視)已屢有報導。
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