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| 1 | 儿童非器质性视力下降临床特征分析显示文摘目的分析儿童非器质性视力下降的临床特征,以期为临床对该疾病快速确诊、避免过度治疗提供依据。方法收集复旦大学附属眼耳鼻喉科医院神经眼科门诊诊断为非器质性视力下降的患儿(年龄<18岁)的病史及临床资料。眼科检查包括裂隙灯检查、眼底照相、最佳矫正视力(BCVA)、视野、光学相干层析成像(OCT)及图形视觉诱发电位(P-VEP)等。结果42例确诊为非器质性视力下降的患儿中,男性13例、女性29例,男/女比为1∶2.23。平均年龄为(9.73±3.02)岁(5~17岁)。单眼患者7例,双眼患者35例。患眼BCVA集中在0.1~0.3(45.45%)及0.4~0.6(36.36%)2个程度分级。38例患者眼底检查显示视盘及黄斑形态正常,4例(7眼,9.09%)患者为假性视盘水肿。42眼视野检查异常,以管状视野、周边视野缺损、弧形缺损及不规则暗点常见,中心暗点少有。所有患者OCT视盘周围视网膜神经纤维层(RNFL)厚度及黄斑区神经节细胞-内丛状层(GCIPL)厚度均在正常范围。所有患者P-VEP P100峰时、潜伏期均未见异常。结论非器质性视力下降患儿主观检查包括BCVA、视野异常,但客观检查包括相对性瞳孔传入障碍(RAPD)、OCT及电生理等一般无异常发现。主客观检查结果的分离对于非器质性视力下降的诊断至关重要。 | 孙平 冯超逸 孙兴怀 陈倩 田国红 | 2022 | 中国眼耳鼻喉科杂志2022，22，1： | 3 |
| 2 | Tests for malingering in ophthalmology显示文摘Simulation can be defined as malingering,or sometimes functional visual loss(FVL).It manifests as either simulating an ophthalmic disease(positive simulation),or denial of ophthalmic disease(negative simulation).Conscious behavior and compensation or indemnity claims are prominent features of simulation.Since some authors suggest that this is a manifestation of underlying psychopathology,even conversion is included in this context.In today's world,every ophthalmologist can face with simulation of ophthalmic disease or disorder.In case of simulation suspect,the physician's responsibility is to prove the simulation considering the disease/disorder first,and simulation as an exclusion.In simulation examinations,the physician should be firm and smart to select appropriate test(s) to convince not only the subject,but also the judge in case of indemnity or compensation trials.Almost all ophthalmic sensory and motor functions including visual acuity,visual field,color vision and night vision can be the subject of simulation.Examiner must be skillful in selecting the most appropriate test.Apart from those in the literature,we included all kinds of simulation in ophthalmology.In addition,simulation examination techniques,such as,use of optical coherence tomography,frequency doubling perimetry(FDP),and modified polarization tests were also included.In this review,we made a thorough literature search,and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology. | Ali Ihsan Incesu | 2013 | International Journal of Ophthalmology(English edition)2013，6，5： | 0 |
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