摘要
特发性颅内压增高(IIH)临床表现为颅内压升高、头痛、视乳头水肿及视野缺损或视力下降等,而脑脊液成分及脑实质磁共振成像正常。IIH发病后可不同程度地影响患者视神经的结构和功能,严重者导致不可逆视力丧失。目前IIH在中国相对少见,大多数眼科医师对这一疾病的病程缺乏足够的了解,导致较高的误诊或漏诊率,延误患者的有效治疗。IIH主要发生于超重/肥胖的育龄女性,其在肥胖发病率较高的西方国家相对常见。近年来,随着我国的肥胖人群逐渐增加,IIH的发病率有增加趋势。由于该病患者的眼部症状及体征比较明显,部分患者首诊于眼科,故眼科和神经科医生对该病的诊治水平亟待提高,以尽可能降低漏诊或误诊率。鉴于目前中国缺乏IIH诊断和治疗的规范性流程,中华医学会眼科学分会神经眼科学组组织有关专家广泛复习和总结相关领域国内外高等级循证证据文献,结合各位专家的临床实践经验,制定了中国特发性颅内压增高(视乳头水肿)诊断和治疗专家共识(2025),为更好地、规范地诊断和治疗IIH患者提出专家推荐意见。
Idiopathic intracranial hypertension(IIH)clinically manifests as increased intracranial pressure,headache,papilledema,and visual field defects or vision loss,while cerebrospinal fluid composition and magnetic resonance imaging brain parenchyma are normal.After the onset of IIH,the morphological structure and function of the patient's optic nerve may be affected to varying degrees,and in severe cases,irreversible vision loss may occur.Since IIH is relatively rare in China,most ophthalmologists do not have a sufficient understanding of the course of this disease,resulting in a high rate of misdiagnosis or missed diagnosis,delaying effective treatment of patients.IIH mainly occurs in overweight/obese women of childbearing age.Due to the high incidence of obesity,IIH is relatively common in Western countries.In recent years,the number of obese people in China has also gradually increased,and the incidence of IIH has an increasing trend.Since the ocular symptoms and signs of patients with this disease are relatively obvious,some patients first visit the ophthalmology department,so the diagnosis and treatment level of ophthalmologists and neurologists for this disease must be urgently improved to minimize the missed diagnosis or misdiagnosis rate.In view of the lack of standardized procedures for the diagnosis and treatment of IIH in China,the Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association and the Neuro-Ophthalmology Society,Chinese Research Hospital Association organized relevant experts to extensively review and summarize high-level evidence-based literature at home and abroad in related fields,and combined with the clinical practice experience of each expert to formulate the Expert consensus on the diagnosis and treatment of idiopathic intracranial hypertension(papilledema)in China(2025)to provide expert recommendations for better and more standardized diagnosis and treatment of IIH patients.
作者
《中国特发性颅内压增高(视乳头水肿)诊断和治疗专家共识(2025)》专家组
中华医学会眼科学分会神经眼科学组
中国研究型医院学会神经眼科专业委员会
魏世辉
张成
李怡文
宋宏鲁
Expert Workgroup of Expert consensus on the diagnosis and treatment of idiopathic intracranial hypertension(papilledema)in China(2025);Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association;Neuro-Ophthalmology Society,Chinese Research Hospital Association;Wei Shihui;Zhang Cheng(不详;Department of Ophthalmology,General Hospital of the People's Liberation Army,Beijing 100853,China;Department of Ophthalmology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)
出处
《中华实验眼科杂志》
北大核心
2025年第5期392-402,共11页
Chinese Journal Of Experimental Ophthalmology
基金
国家中医药管理局--重大疑难疾病中西医临床协作项目。
关键词
特发性颅内压增高
视乳头水肿
视力障碍
头痛
假性脑瘤
肥胖
共识
Idiopathic intracranial hypertension
Papilledema
Visual impairment
Headache
Pseudotumor cerebri
Obesity
Consensus
