Clinical analysis of neuro-ophthalmological features in 45 patients with intracranial aneurysm / 中华眼底病杂志

ABSTRACT

Objective To observe the neuro-ophthalmological features of intracranial aneurysm.Methods 169 patients with intracranial aneurysm were retrospectively studied.45 patients, including 18 men and 27 women, had neuro ophthalmological symptoms or signs.Their average age was (56.21 ± 16.11) years and 32 (71.11％)patients' age was more than 50 years.The onset time ranged from 30 minutes to 20 years.20 (44.44％) patients' onset time was among 24 hours.CT, CT angiography, MRI, MRI angiography and cerebral digital subtraction angiography were performed alone or combined in all 45 patients.Visual acuity, pupil reflex and eye movement were examined.Clinical data including general condition, initial symptoms, neuro-ophthalmological changes, imaging data and treatment effects were recorded.Results 26.63％ of the 169 patients had neuro-ophthalmological symptoms or signs.There were 6 patients (13.33％) with neuro ophthalmological changes as their first manifestation and 39 patients (86.67 ％) with neurologic changes as first manifestation.Neuro-ophthalmological symptoms included vision loss (10 patients, 22.22％), diplopia (4 patients, 8.89％) and ocular pain (2 patients, 4.44％).The most common neuro-ophthalmological sign was pupil abnormality which was found in 31 patients (68.89 ％).The second most common sign was eye movement disorder (16 patients, 35.56％).The other signs included ptosis (8 patients, 17.78％), nystagmus (2 patients, 4.44％), exophthalmos (1 patient, 2.22％) and disappeared corneal reflection (1 patient, 2.22％).Imaging examination indicated that intracranial hemorrhage happened in 29 patients (64.44％).The most common neuro-ophthalmological features were pupil abnormality, eye movement disorder and vision loss in both patients with or without intracranial hemorrhage.The incidence of pupil abnormality was higher in patients with intracranial hemorrhage than that without intracranial hemorrhage, the difference was statistically significant (x2=7.321, P=0.007).Pupil abnormality and vision loss were common in patients with internal carotid artery aneurysm, and eye movement disorder was common in patients with internal carotid artery aneurysm and posterior communicating aneurysms.Conclusions Patients with intracranial aneurysm have different neuroophthalmological features.The most common features are pupil abnormality, eye movement disorder and vision loss.