The Retrospective Study On Neuro-Ophthalmology Features For Neurology Inpatients

[Objects]Preliminary study about the basic characteristics of neurological hospitalized patients in the aspects of Neuro-Ophthalmology. for the further development of the Neuro-Ophthalmology and to direct clinical treatment better.[Methods]We collected the patients who had Neuro-Ophthalmology symptoms and signs in Neurology department of the PLA General Hospital from June 1,2009 to June 1,2010, using retrospective method to study the disease constitution and the main clinical manifestations, then use statistical analysis to get the conclusion.[Results]1.160 patiotus who had neuro-ophthalmology disorders were selected from 651 patients, which representing 24.57% of the total number of Neurology hospitalizations in the same period.The age of patients was from 13-86 years old. with a median of 54 years old.and was non-normal distribution.The sex constituent ratio between men and women is 1.35;2. Clinical manifestations:44 diplopia 43 eye movement disorders, 42 people sustained vision loss, nystagmus 38: 89.38% with abnormal imaging,5.63% witth abnormal ophthalmic instruments tests;3. Constitute of the main diseases:cerebral infarction 49. NMO 17, MG 15. cerebral hemorrhage 14, vertebrobasilar insufficiency 12, CVST 5, MS 5, inflammatory demyelinating disease 5 and malignant brain tumor 8 and so on. which accounted for 81.25%.4. Pathological nature:92 patients were cerebral circulation disorders,48 patients were non-infectious inflammation, S patients was malignant tumors.4 patients were intracranial infection inflammation,3 were trauma,2 was poisoning,3 was unknown reasons.5. The diseases which More commonly involves the visual afferent system are NMO, CVST.The diseases which more commonly involves the visual efferent system are cerebral infarction, cerebral hemorrhage, vertebrobasilar insufficiency. MG, and inflammatory demyelinating diseases.The diseases which both involves the afferent system and efferent system are malignant brain tumor and MS.6. Treatment effect of neuro-ophthalmology disorders:51.87% improved,5.63% cured, 25% unchanged,1.88% deterioration,15.62% with no record,7. The relationship between diplopia and brain stem infarction was statistically significant (P =0.0201); the relationship between sustained vision loss and the NMO was statistically significant (P=0.000), and the relationship between sustained vision loss and MS or intracranial malignant tumors was statistically significance; the relationship between eye movement disorders and cerebral infarction is statistically significant (P=0.0036); the relationship between nystagmus and cerebral infarction is statistically significant (P 0.0103).[Conclusions]1. 24.57% of total neurology inpatients had neoro-ophthalmogy manifestations.2. The most common clinical manifestations are diplopia, eye movement disorder, sustained vision loss and nystagmus. Brainstem infarction can be diagnosed by diplopia, NMO, MS, and brain cancer can be diagnosed by sustained vision loss. Cerebral infarction can be diagnosed by eye movement disorders or nystagmus.3. Neuro-ophthalmogy disease spectrum of neurology includes cerebral infarction. NMO, MG, cerebral hemorrhage, vertebrobasilar insufficiency, CVST, MS, inflammatory demyelinating disease and malignant brain tumor; pathologycal disorders mainly are cerebral circulation and non-infectious inflammation. NMO and CVST more commonly involved the visual afferent system, cerebral infarction, cerebral hemorrhage, vertebrobasilar insufficiency, MG, and inflammatory demyelinating diseases more commonly involved the visual efferent system, cancer and MS involved both the two systems.4. Neurologists should pay more attention to the ophthalmology examination and treatment.