Protocolo diagnóstico-terapéutico del paciente con pérdida aguda de visión

  1. Alberte Woodward, M. 1
  2. Abalo Lojo, J.M. 2
  3. Prieto González, J.M.Ó. 1
  1. 1 Servicios de Neurología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
  2. 2 Servicios de Oftalmología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Ano de publicación: 2023

Título do exemplar: Enfermedades del sistema nervioso (IX): Enfermedades desmielinizantes

Serie: 13

Número: 78

Páxinas: 4655-4659

Tipo: Artigo

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Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumo

Recent vision loss is a common complaint, more often unilateral than bilateral. The temporal pattern of onset may be classified into transient, hyperacute, acute, and subacute-chronic losses, and the presence or absence of pain is also a relevant criterion. Among transient losses, amaurosis fugax is worth highlighting because it may herald an established ischemic stroke. Among hyperacute losses, urgent diagnosis of central retinal artery occlusion is imperative, given the possibility of reperfusion treatment with alteplase (off-label) in the first 4.5 hours. In acute forms, the presence or absence of papillitis distinguishes between anterior and posterior (or retrobulbar) optic neuropathies, the latter being typical of demyelinating processes. In either transient, hyperacute and acute forms, and especially in the context of pain, identification of an arteritic process is mandatory as it would dictate the urgent initiation of corticosteroid therapy.

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Fonte de datos: Dialnet