A case of progressive and irreversible visual loss as a consequence of delayed diagnosis in cerebrospinal fluid venous fistula.

IF 1.4 4区 医学 Q3 OPHTHALMOLOGY
Lucio Zeppa, Maria Laura Passaro, Amedeo Guida, Fabio Tortora, Carlo Petruzziello, Michele Rinaldi, Ciro Costagliola
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引用次数: 0

Abstract

PurposeCerebrospinal fluid venous fistulas (CVFs) are a frequently underrecognized cause of cerebrospinal fluid (CSF) leaks, leading to intracranial hypotension and a wide range of symptoms, including visual disturbances. This case highlights the critical role of ophthalmologists in identifying CVFs as a cause of unexplained progressive vision loss.MethodsWe present the case of a 45-year-old woman who developed progressive visual field loss over 15 years, ultimately resulting in blindness in one eye. Early neuroimaging and testing were normal despite symptoms of orthostatic headaches, photophobia, and hearing loss. Advanced imaging eventually identified a CVF at the T8 level. Surgical correction was performed, and the patient's clinical response was assessed.ResultsSurgical repair of the CVF led to clinical improvement, halting further progression of symptoms.ConclusionsCVFs should be considered in patients with unexplained visual disturbances, particularly when accompanied by symptoms of intracranial hypotension. Early suspicion and collaboration with neurologists and neuroradiologists are essential for timely diagnosis and intervention. Ophthalmologists play a pivotal role in guiding appropriate referrals, ensuring multidisciplinary care to prevent irreversible visual and systemic complications.

脑脊液静脉瘘延迟诊断导致进行性和不可逆视力丧失1例。
脑脊髓液静脉瘘(CVFs)是脑脊液(CSF)泄漏的一个经常被忽视的原因,导致颅内低血压和广泛的症状,包括视力障碍。本病例强调了眼科医生在确定CVFs是无法解释的进行性视力丧失的原因时的关键作用。方法我们报告了一位45岁的女性,她在15年的时间里发展为进行性视野丧失,最终导致一只眼睛失明。尽管有直立性头痛、畏光和听力丧失等症状,但早期神经影像学检查正常。高级成像最终确定了T8水平的CVF。进行手术矫正,并评估患者的临床反应。结果CVF的手术修复导致临床改善,阻止了症状的进一步发展。结论伴有不明原因视力障碍的患者应考虑scvfs,特别是伴有颅内低血压症状的患者。早期怀疑以及与神经学家和神经放射学家的合作对于及时诊断和干预至关重要。眼科医生在指导适当转诊方面发挥关键作用,确保多学科护理以防止不可逆的视觉和全身并发症。
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来源期刊
CiteScore
3.60
自引率
0.00%
发文量
372
审稿时长
3-8 weeks
期刊介绍: The European Journal of Ophthalmology was founded in 1991 and is issued in print bi-monthly. It publishes only peer-reviewed original research reporting clinical observations and laboratory investigations with clinical relevance focusing on new diagnostic and surgical techniques, instrument and therapy updates, results of clinical trials and research findings.
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