Medically unexplained visual loss in a specialist clinic: a retrospective case-control comparison

作者：O'Leary Eanna D^*; McNeillis Benjamin; Aybek Selma; Riordan Eva Paul; David Anthony S

来源：Journal of the Neurological Sciences, 2016, 361: 272-276.

DOI：10.1016/j.jns.2015.12.045

• Medically unexplained vision loss
• Functional vision loss
• Visual reduction
• Psychological
• Conversion disorder
• Neuro-ophthalmology

Purpose: To compare the clinical and demographic characteristics of adult patients with nonorganic or medically unexplained visual loss (MUVL) to those with other common conditions presenting to a neuro-ophthalmology clinic.
Methods: Case-control design: a retrospective review of medical notes on a consecutive case series of 49 patients assessed at the King's College Hospital neuro-ophthalmology clinic with unexplained visual loss and matched with the next assessed patient identified from clinic records. Patients presented post-symptom onset with a mean clinical course of 30 months (SD = 67 months) and standard clinical examination used to confirm diagnoses, alongside ancillary investigations if required.
Results: Seventy-two percent (n = 36) of MUVL patients were female. In comparison with patients with organic visual disorders, MUVL cases presented with significantly higher rates of bilateral (cf. unilateral) visual impairment (41%, n = 20), premorbid psychiatric (27%, n = 13) as well as functional (24%, n = 12) diagnoses and psychotropic medication usage (22%, n = 11). Medically unexplained cases were significantly more likely to report preceding psychological stress (n = 9; 18%).
Conclusions: Medically unexplained visual impairment may be regarded as part of the spectrum of medically unexplained disorders seen in the general hospital setting. Research is needed to determine long-term outcomes and effective tailored interventions.

• 出版日期2016-2-15