【摘要】 目的:研究早期帕金森病(PD)患者视觉功能特点,为临床诊断和治疗PD提供一定的参考。方法:选取2011年1月至2012年12月我院神经内科门诊诊断为早期PD的患者29例作为实验组,选择我院体检中心体检的健康志愿者30例作为对照组,所有受试者均未接受过抗PD药物和眼科治疗。对研究对象进行神经科检查和眼科检查,采用Hoehn-Yarh评级和统一帕金森病评分量表(UPDRS)对疾病进行评级和评分。视觉功能检查包括对比度视力、集合及调节功能。对比度视力采用E字视标早期糖尿病视网膜病变治疗研究计划视力表(ETDRS视力表)分别测量100%、25%、10%三个对比度视力。比较两组视觉功能是否存在差异。结果:实验组和对照组之间高对比度视力差异无统计学意义(t=0.16,P=0.8),但低对比度(25%、10%)时,实验组视力显著低于正常组(t值分别为-2.58和-3.24,P值分别为0.012和0.002);实验组集合近点略大于对照组,分别为(6.4±4.35)cm和(4.7±3.39)cm,但差异无统计学意义(t=-1.69,P=0.09)。实验组和对照组正融像能力分别为(15.0±5.23)△,(19.2±6.97)△,两组之间差异有统计学意义(t=2.60,P=0.01);实验组和对照组诊断为集合不足者分别为9例和2例(x2=5.78,P=0.016);实验组和对照组调节幅度分别为(2.4±1.1)D和(2.2±0.9)D,两组之间差异无统计学意义(t=0.90,P=0.37);实验组中有7例出现视幻觉,对照组中无一例存在视幻觉,两组之间差异有统计学意义(x2=6.07,P=0.014)。结论:PD患者在早期已经出现视觉功能障碍,包括低对比度视力下降、正融像能力降低等,而视觉功能降低可能是产生视幻觉的原因之一。更多还原

【Abstract】 Objective: To investigate the characteristic of the visual function of early Parkinson’s disease(PD) patients and to provide some guidance for clinical diagnosis and treatment.Methods: Fifty-nine subjects were enrolled in this study,including 29 early PD patients in the experimental group and 30 normal subjects in the control group.All subjects didn’t receive any anti-Parkinson’s disease drugs and ophthalmologic treatment.HoehnYahr stages and Unified Parkinson’s Disease Rating Scale(UPDRS) were used to evaluate the PD patient’s stage and severity degree.Visual function tests included contrast visual acuity,convergence and accommodative amplitude.ETDRS eyesight chart was used to measure the 100%,25% and 10% contrast visual acuity,respectively.The eyesight function checking was compared to find whether there was a difference between the two groups.Results: There was no significant difference(t=0.16,P=0.8) in 100% high contrast visual acuity between early PD patients and control group,but in 25% and 10% low contrast,the visual acuity of early PD patients was significantly lower than that of control group(t=-2.58,-3.24,P=0.012,0.002,respectively).Near point convergence of early PD patients and control group were(6.4 ± 4.35) cm and(4.7 ± 3.39) cm respectively,but there was no significant difference between the two groups(t=-1.69,P=0.09).Positive fusion convergence of early PD patients was(15.0 ±5.23)△,significantly lower than that in the control group,which was(19.2 ± 6.97)△(t=2.60,P=0.01).Convergence insufficiency was diagnosed in 9 early PD patients compared to 2 subjects from the control group(x 2 =5.78,P=0.016).The accommodative amplitude had no significant difference between early PD patients and control group(t=0.90,P = 0.37).Seven early PD patients had visual hallucinations,but nobody in the control group had this symptom(x 2 = 6.07,P=0.014).Conclusion: There are various kinds of visual dysfunctions that exist in early PD patients,including decreased low-contrast visual acuity,positive fusion convergence,and increased near point convergence.These visual dysfunction are possible causes of visual hallucinations in early PD patients.更多还原