[In Press] Optical coherence tomography angiography of optic disc perfusion in non-arteritic anterior ischemic optic neuropathy

AIM: To compare the optic disc blood flow of non-arteritic ischemic optic neuropathy (NAION) eyes with normal eyes.. METHODS: The optic disc blood flow densities of diagnosed non-acute phase NAION eyes (21 eyes, 14 individuals) and normal eyes (19 eyes, 12 individuals) were detected via Optovue optical coherence tomography angiography (OCTA). The optic disc blood flow was measured via Image J software. Correlations between optic disc perfusion and visual function variables were assessed by linear regression analysis. RESULTS: The average percentage of the optic disc non-perfusion areas in the non-acute phase NAION patients (17.84%±6.18%) was increased, when compared to the normal control eyes (8.61%±1.65%), and the difference was statistically significant (p < 0.01). Moreover, there was a proportional correlation between the visual field mean defect (MD) and the optic disc non-perfusion area percentage, and the relationship was statistically significant (t = 3.65, p < 0.01, R2 = 0.4118). In addition, the critical correlation between the best corrected visual acuity (BCVA) and the optic disc non-perfusion area percentage was statistically significant (t = 4.32, p < 0.01, R2 = 0.4957). CONCLUSION: The optic disc non-perfusion area percentages detected via OCTA in NAION eyes were significantly increased when compared with the normal eyes. Both the BCVA and MD were correlated with the optic disc flow detected, revealing that OCTA may be valuable in the diagnosis and estimation of NAION.     

Analysis of optic disc damage by optical coherence tomography in terms of therapy in non-arteritic anterior ischemic optic neuropathy

This study aimed to assess the relationship between the rate of nerve fiber loss in non-arteritic anterior ischemic optic neuropathy (NAION) and time delay before therapy. Total 24 patients received the same treatment within or after 2wk (early and late groups). There were significantly lower level of destruction of nerve fibers (P=0.0014) and significantly better visual field sensitivity (P=0.039) in early group. The results indicate that therapy should be started within 2wk. The degree of ischemic damage due to NAION correlates well with retinal nerve fiber layer thickness and the ischemia-induced decrease in visual field sensitivity.     

非动脉炎性前部缺血性视神经病变患者OCTA视盘量化参数及其与病程、视力预后的关系

目的 应用相干光断层扫描血管成像(OCTA)研究不同病程的非动脉炎性前部缺血性视神经病(NA-AION)的影像特征及视盘量化参数,并探讨其与病程、视力预后之间的关系.设计回顾性病例系列.研究对象2019年1-6月就诊于南京医科大学附属眼科医院的NA-AION患者24例(24眼).方法 回顾分析临床确诊为NA-AION患...     

非动脉炎型前部缺血性视神经病变的临床特点分析

目的　探讨非动脉炎型前部缺血性视神经病变（ｎｏｎ-ａｒｔｅｒｉｔｉｃａｎｔｅｒｉｏｒｉｓｃｈｅｍｉｃｏｐ-ｔｉｃｎｅｕｒｏｐａｔｈｙ,ＮＡＩＯＮ）的临床特点。方法　回顾性分析２０１０年１月至２０１３年１２月首诊于我院的６６例（８３眼）ＮＡＩＯＮ患者的临床资料,包括视力、眼压、视野、荧光素眼底血管造影和ＯＣＴ等检查结果,并对患者全身疾病进行相关分析,观察治疗过程中视力、视野恢复情况及眼底变化。结果　在ＮＡＩＯＮ患者中单眼４９眼,双眼先后发病１３眼,双眼同时发病４眼,其中,７０％双眼先后发病的患者在对侧眼出现ＮＡＩＯＮ时,先发病眼视力得到改善。ＯＣＴ检查发现:ＮＡＩＯＮ患者的视盘水肿主要发生于视盘的上方和下方,形成“双驼峰”状改变。在发病早期２０眼发生黄斑中央凹神经上皮层脱离。发生黄斑渗出的眼中８０％合并糖尿病。结论　颞侧视盘的神经纤维层增厚牵拉所导致的中心凹神经纤维层脱离,可能是早期ＮＡＩＯＮ视力低的因素。双眼发病的ＮＡＩＯＮ患者,可能存在双眼视盘供血代偿机制,来减轻一侧视盘的损害。     

非动脉炎性前部缺血性视神经病变与腹型肥胖的相关性研究

目的:探讨腹型肥胖与非动脉炎性前部缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy,NAION)发生的相关性。方法:连续收集45例中国陕西籍或长期居住在北方地区的汉族NAION患者作为观察对象(即NAION组),并且无糖尿病、严重心脑血管疾病、肝肾功能不全等疾病;选择45例按年龄、性别、体质量指数条件与观察对象相匹配的健康查体者或其它眼病患者,自愿参与作为对照组。男性腰围≥85cm,女性腰围≥80cm,定义为腹型肥胖。结果:NAION组中腹型肥胖31例(69%)高于对照组21例(47%),两者比较有统计学差异(P<0.05);NAION组中吸烟者26例(58%),饮酒者20例(44%),对照组中吸烟者11例(24%),饮酒者16例(36%),吸烟方面两组间有统计学差异(P<0.05),而饮酒在两组间无统计学差异(P>0.05)。结论:中国北方汉族人群腹型肥胖与NAION发病有一定的关系。     

长春胺缓释胶囊治疗非动脉炎性前部缺血性视神经病变的疗效及安全性

目的:观察长春胺缓释胶囊治疗非动脉炎性前部缺血性视神经病变的临床疗效及安全性.方法:将2015-01/09来我院就诊的急性期发病的单眼非动脉炎性前部缺血性视神经病变(non-arteritic ischemic optic neuropathy,NAION)患者42例42眼,随机分为对照组(15例15眼)、治疗组(27例27眼),所有患者均给予大剂量激素(甲基强的松龙500~1000mg)、维生素B1、甲钴胺片营养神经治疗的同时,治疗组给予长春胺缓释胶囊口服治疗,30 mg/次,每天2次,疗程为3 mo.观察比较两组患眼治疗前后最佳矫正视力(best corrected visual acuity,BCVA)、平均视野缺损(mean deviation,MD)、平均盘周神经纤维层厚度(retinal nerve fiber layer,RNFL)、视网膜神经节细胞复合体厚度(ganglion cell complex,GCC)、图形视觉诱发电位(pattern visual evoked potential,PVEP)P100波潜伏期及振幅等变化.结果:治疗后,治疗组患眼视力治疗有效率较对照组高;治疗组与对照组患眼MD均较治疗前降低,差异有统计学意义(t=2.342、2.692,P=0.027、0.041).治疗后,治疗组与对照组PVEP振幅较治疗前均未见明显变化,差异无统计学意义(t=1.952、1.840,P=0.062、0.089);治疗组与对照组PVEP潜时值与治疗前比较无统计学差异(t=2.018、1.301,P=0.054、0.216);治疗组与对照组盘周神经纤维层厚度、神经节细胞复合体厚度都比治疗前变薄,差异均有统计学意义(P<0.001),对照组萎缩程度更严重.两组治疗均有效,治疗组效果优于对照组.尚未发现与长春胺缓释胶囊的口服治疗相关的不良事件发生.结论:长春胺缓释胶囊治疗NAION具有较好的临床疗效及安全性,能够起到辅助治疗、减少视神经损伤的作用.     

非动脉炎性前部缺血性视神经病变眼微视野固视性质分析

目的:分析非动脉炎性前部缺血性视神经病变(NAION)眼的微视野固视性质。方法:选择NAION患者23例27眼,分别以检眼镜法和Nidek MP-1微视野仪检测其固视性质,并对检测结果进行比较。结果:以检眼镜法检测,18眼表现为中心固视,9眼表现为中心外固视;以微视野法检测,18眼表现为稳定的中心固视,9眼表现为中心外固视,其中相对不稳定固视6眼,不稳定固视3眼。中心固视眼视力明显好于中心外固视眼(P<0.05)。结论:检眼镜法检测NAION患者的固视性质时可以明确区分中心固视和中心外固视,微视野法则可以进一步对固视的稳定性加以分析。     

视神经炎和前段缺血性视神经病变及视乳头水肿的视野改变分析

目的:比较特发性脱髓鞘性视神经炎(idiopathic demyelinating optic neuritis,IDON)、非动脉炎性前段缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy,NAION)和视乳头水肿(papilledema,PE)患者的视野变化特点,分析其发生机制。方法:回顾性病例研究。收集2011-03/2012-05期间在中国医科大学附属第四医院眼科诊治的IDON,NAION和PE患者的视野资料,记录患者的年龄、性别组成、最佳矫正视力(BCVA)、瞳孔大小、完成视野检测的时间、视野缺损的类型、部位、平均缺损(MD)和模式缺损(PSD)情况,SPSS 12.0统计软件包比较三组患者之间的差异。结果:IDON患者17例20眼,NAION患者21例26眼,PE患者11例22眼。三组患者平均年龄、性别比例、BCVA、瞳孔大小、完成视野检测的时间、视野MD和PSD的差异均具有统计学意义(P<0.05)。结论:IDON,NAION和PE患者的视野表现复杂多样,但又各有特点,这与三种疾病的发病机制密切相关,为视神经疾病的鉴别诊断提供依据。     

Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis

AIM: To assess the differences in average and sectoral peripapillary retinal nerve fiber layer (pRNFL) thickness using spectral domain optical coherence tomography (SD-OCT) in patients with non-arteritic anterior ischemic neuropathy (NAION) compared with those with primary open angle glaucoma (POAG).METHODS: A comprehensive literature search of the PubMed, Cochrane Library, and Embase databases were performed prior to October, 2021. Studies that compared the pRNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included. The weighted mean difference (WMD) with 95% confidence interval (CI) was used to pool continuous outcomes.RESULTS: Ten cross-sectional studies (11 datasets) comprising a total of 625 eyes (278 NAION eyes, 347 POAG eyes) were included in the qualitative and quantitative analyses. The pooled results demonstrated that the superior pRNFL was significantly thinner in NAION eyes than in POAG eyes (WMD=-6.40, 95%CI: -12.22 to -0.58, P=0.031), whereas the inferior pRNFL was significant thinner in POAG eyes than in NAION eyes (WMD=11.10, 95%CI: 7.06 to 15.14, P≤0.001). No difference was noted concerning the average, nasal, and temporal pRNFL thickness (average: WMD=1.45, 95%CI: -0.75 to 3.66, P=0.196; nasal: WMD= -2.12, 95%CI: -4.43 to 0.19, P=0.072; temporal: WMD= -1.24, 95%CI: -3.96 to 1.47, P=0.370).CONCLUSION: SD-OCT based evaluation of inferior and superior pRNFL thickness can be potentially utilized to differentiate NAION from POAG, and help to understand the different pathophysiological mechanisms between these two diseases. Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.     

先天性视盘占位病变继发非动脉炎性前部缺血性视神经病变的临床特征分析

目的 探讨先天性视盘占位病变相关的非动脉炎性前部缺血性视神经病变（NAION）的临床特征。设计 回顾性病例系列。研究对象 2010年1月-2019年6月北京同仁医院先天性视盘占位病变继发NAION患者9例（11眼）。方法 回顾及分析患者的眼科及头颅神经影像学资料。所有患者均经半年以上随访。主要指标 性别、年龄、发病眼别、视盘病变特征及与视野改变关系、头颅神经影像学表现。结果 9例继发NAION的先天性视盘占位病变中4例视盘黑色素细胞瘤,3例视盘内玻璃膜疣,2例视盘区残存有髓纤维。年龄26~65岁（中位数39岁）。7例单眼发生NAION,2例视盘内玻璃膜疣患者双眼先后发生NAION。发生NAION时患眼矫正视力0.05~1.0。可行视野检查的4例患者表现为水平下半缺损及向心性缩小。最后随访时均无视功能进行性损伤和病情复发。结论 先天性视盘占位性病变可继发NAION而出现视功能损伤。（眼科, 2020, 29： 141-146）     

剔络化瘀养血明目法对早期非动脉炎性前部缺血性视神经病变患者视功能的影响

目的 探讨剔络化瘀养血明目法对早期非动脉炎性前部缺血性视神经病变患者视功能的影响.方法 回顾性分析2012年5月至2014年5月在我院住院部经剔络化瘀养血明目法治疗的早期非动脉炎性前部缺血性视神经病变患者21例(24眼).经归元剔络化瘀方、改善微循环类药物、营养神经类药物治疗2个疗程.观察治疗前后最佳矫正视力、视野的变化.结果 早期非动脉炎性前部缺血性视神经病变患者经剔络化瘀养血明目法治疗2个疗程后,视力提高0.18±0.24,较治疗前差异有显著统计学意义(P＜0.01);视野敏感度提高(2.34±3.65)dB,较治疗前差异有统计学意义(P＜0.05);视野缺损降低(-2.26±3.81)dB,较治疗前差异无统计学意义(P＞0.05).结论 剔络化瘀养血明目法能有效改善早期非动脉炎性前部缺血性视神经病变患者的视功能.     

Acute changes in ganglion cell layer thickness in ischemic optic neuropathy compared to optic neuritis using optical coherence tomography

AIM:To elucidate the changes of different ganglion cell layer(GCL)thinning patterns between the optic neuritis(ON)and non-arteritic anterior ischemic optic neuropathy(NAION).METHODS:A prospective,observational study was conducted to evaluate the timing of GCL changes between acute ON and NAION using optical coherence tomography.RESULTS:Thinning on optical coherence tomography in the NAION group occurs as early as 11 d after symptomatic onset of vision loss and follows an altitudinal pattern.The mean superior-inferior GCL thickness difference in the NAION cohort was clinically significant at 5.7μm in the NAION cohort compared to controls of 0.8μm(P=0.032),but not significant in the ON group compared to controls with both groups measuring 1.1μm.Global thinning was significant for the ON group compared to controls at 7.2μm(P=0.011)but not the NAION group compared to controls at 1.35μm.CONCLUSION:These findings suggest that future treatments for NAION should be given early,and possibly before 11 d in order to prevent GCL and irreversible vision loss.     

非动脉炎性前部缺血性视神经病变治疗进展

非动脉炎性前部缺血性视神经病变(nonarteritic anterior ischemic optic neuropathy,NAION)是全身血管危险因素及局部解剖因素等多因素共同参与的、发病机制复杂的视神经缺血性疾病.控制全身危险因素是治疗关键.目前三大治疗尝试包括改善循环(如眼压干预、体外反搏、手术),减轻视盘...     

青光眼与非炎症性缺血型视神经病变的傅立叶OCT扫描视神经形态学对比

目的 比较青光眼与非炎症性缺血型视神经病变(non-arteritic ischemic optic neuropathy,NAION)患者患眼的视盘及盘周视网膜神经纤维层(peripapillary retinal nerve fiber layer,pRNFL)参数变化情况及诊断能力.方法 选择我院眼科年龄≥40岁就诊患者71例(71眼).受试者分为青光眼组26例、NAION组15例、对照组30例,排除视野缺损范围大于两个象限或等效球镜度数大于±6D的受试眼以及发病时间小于6个月的NAION患眼.所有患者均接受眼部常规检查,使用傅立叶OCT测量视盘及pRNFL各参数.结果 3组之间除视盘面积外(P =0.059),其余视盘及pRNFL各参数差异均有统计学意义(均为P＜0.05).经LSD两两比较发现:青光眼组的视杯面积(1.438±0.714)mm2最大(均为P ＜0.05),盘沿面积(0.965 ±0.652)mm2最小(均为P＜0.05),盘沿容积和视神经盘容积[(0.103 ±0.089)mm3、(0.195±0.168)mm3]最小(均为P＜0.05),视杯容积(0.482 ±0.420)mm3最大(均为P ＜0.05),杯盘比最大(均为P＜0.05);NAION组的视杯面积(0.493±0.344) mm2最小(均为P＜0.05),盘沿面积(1.255±0.294) mm2与对照组(1.243±0.509) mm2差异无统计学意义(P＞0.05),盘沿容积(0.196±0.094)mm3、视神经盘容积(0.339±0.109) mm3与对照组差异均无统计学意义(均为P＞0.05),视杯容积(0.083 ±0.073)mm3最小(均为P＜0.05),杯盘比最小(均为P＜0.05).在pRNFL方面,经LSD两两比较发现:3组在平均值及TU、ST、SN、NU、IT区之间两两比较差异均有统计学意义(均为P＜0.05);在NL、IN、TL区,青光眼组与对照组两两比较差异均有统计学意义(均为P ＜0.05).将青光眼组与对照组进行AROC分析发现:视盘参数中除视盘面积外(P＞0.05),其他参数及所有pRNFL各参数差异均有统计学意义(均为P＜0.05).将NAION组与对照组进行AROC分析发现:pRNFL中的上方(即ST、SN区)、鼻上(即NU区)和下方偏颞侧(即IT区)AROC差异均有统计学意义(均为P＜0.05),视盘所有参数及pRNFL其余部位差异均无统计学意义(均为P ＞0.05).将NAION组与青光眼组进行AROC分析发现:视盘参数中视杯面积、视杯容积、杯盘比(包括面积、水平和垂直)的AROC差异均有统计学意义(均为P＜0.05),而pRNFL中的颞上方(即TU区)、鼻上方(即NU区)和平均值AROC差异均有统计学意义(均为P＜0.05),其余部位差异均无统计学意义(均为P＞0.05).结论 通过傅立叶OCT检测可发现青光眼与NAION在视盘及pRNFL方面的差异,为理解此两种视神经疾病的发病特点及鉴别诊断提供临床依据.     

非动脉炎性前部缺血性视神经病变的危险因素分析

目的观察非动脉炎性前部缺血性视神经病变(NAION)的危险因素,为该病提供防治措施。方法对我院2009年至2013年5年间住院的并确诊为NAION的患者和同期体健中心的体检人群的实验室检查、24 h血压、全身及一般情况、眼部检查等进行分析,籍以说明其患病的危险因素,深入研究各种因素与该病的相互关系及特点,并通过临床干预性治疗,显现出该研究对此类疾病预后的影响。结果病例组发病年龄(57.89±10.32)岁,男性占47.84%,女性占52.16%。病例组中高血压、高血糖、胆固醇、甘油三酯、红细胞压积偏低及颈动脉超声异常的比例分别是49.07%、33.02%、23.53%、29.9%、8.25%及59.73%。对照组年龄(54.02±11.85)岁,男性占57.58%,女性占42.42%,高血压、高血糖、胆固醇、甘油三酯、红细胞压积偏低及颈动脉超声异常比例分别是23.64%、10%、16.97%、27.87%、7.57%及41.05%。结论病例组高血压、高血糖、高血脂、红细胞压积偏低、颈动脉超声异常及夜间低血压发病率明显高于对照组。且病例组发病年龄有年轻化的趋势,男性略高于女性,高血压、高血糖、血脂、颈动脉异常及夜间低血压等是主要的危险因素。对于NAION的患者应积极查找全身病因,并给予有效干预。对高危人群和已患病人群做出高发病例、治疗预后等情况做出科学的评估。     

非动脉炎性前部缺血性视神经病变患者急性期视盘周围脉络膜血流信号分析

目的　利用光学相干断层扫描血管成像（OCTA）观察非动脉炎性前部缺血性视神经病变（NAION）患者急性期的视盘周围脉络膜血流信号特征。方法　对2017年1月至2019年9月首次确诊为NAION且接受OCTA检查的13例（13眼）患者进行回顾性横断面研究。由两位医师分别定性分析OCTA中脉络膜毛细血管层的血流信号中的低信号区,并分区。将分区的结果与en face OCT、视野检查结果进行对比。患者均至少随访1个月。结果　急性期NAION患眼的视盘OCTA在脉络膜毛细血管层水平的低信号区可分为视盘本身部位、视盘水肿部位和沿神经纤维方向延伸部位3个区域。13眼中,10眼首次就诊时出现3个低信号区,2眼在第2次就诊时出现3个低信号区,1眼仅出现视盘本身部位和视盘水肿部位的低信号区。其中,沿神经纤维方向延伸部位的低信号区与视野缺损关系密切,对应比例达91.6%,该低信号区平均出现时间为发病后19.9 d。随访期内,9眼沿神经纤维方向延伸部位的低信号区出现神经纤维层萎缩。结论　NAION患者急性期的视盘周围脉络膜层面的血流信号可以通过OCTA提示神经纤维层水肿、消退以及萎缩的变化过程。     

高海拔地区非颞动脉炎性前部缺血性视神经病变的病因与临床研究

目的:探讨高海拔地区非颞动脉炎性前部缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy,NAION)的发病因素与临床的相关研究。方法:将2011-03/2012-09来我科门诊就诊,并确诊为NAION的住院患者纳为病例组。并将同一时期来我院参加门诊体检并与病例组年龄、性别相匹配的人群作为对照组。将纳入对象的个人资料进行详细登记和详尽的眼科检查,并进行血压监测及血常规、血脂、血糖、血液流变等化验检查,并将观察指标详细记录。结果:病例组与对照组之间总胆固醇、HDL-脂蛋白、血常规无统计学差异(P>0.05),而甘油三脂、血糖、血压有统计学差异(P<0.05),NAION组较高。全血黏度高切、血浆黏度、全血还原黏度中切、红细胞变形指数、血沉、血沉方程K值二组之间无统计学差异(P>0.05),而全血黏度中低切、红细胞压积、全血还原黏度高低切、红细胞聚集指数有统计学差异(P<0.05),NAION组较高。结论:高海拔地区NAION的发病因素不是单一的,是多因素相互作用的结果。高海拔低压低氧等环境条件下,NAION的发病与人体微循环发生的一系列病理生理变化相关。甘油三脂、血压、血糖对高海拔地区NAION的发生具有统计学差异(P<0.05)。高血黏度是高海拔地区NAION发生的危险因素。应加强高海拔地区人群对NAION的健康教育,提高其对NAION防治的认识。     

Optic disc edema in non-arteritic anterior ischemic optic neuropathy

We investigated the clinical characteristics, time to resolution and the factors that influence it, and evolutionary pattern of optic disc edema (ODE) in non-arteritic anterior ischemic optic neuropathy (NA-AION). Our study was conducted in 591 consecutive patients (749 eyes) with NA-AION who fulfilled our inclusion criteria. On their first visit to our clinic, all patients had a detailed ophthalmic and medical history, a comprehensive ophthalmic evaluation, and stereoscopic color fundus photography and fluorescein fundus angiography. On each follow-up visit, the same ophthalmic evaluation was performed, except for fluorescein fundus angiography. The effect of steroid therapy on ODE was evaluated in a “patient choice study” in 723 eyes, i.e., patients who voluntarily opted to have (343 eyes) or not have (380 eyes) this therapy. To identify the factors that influence time to ODE resolution, parametric regression models for interval-censored data were fitted by maximum likelihood estimation using an SAS procedure. Our results indicate that the overall median time (25–75th percentile) to spontaneous resolution of ODE from the onset of visual loss was 7.9 (5.8–11.4) weeks. The ODE resolution time was longer in diabetics than in non-diabetics (p = 0.003) in the single factor model. Multi-factor analysis showed that worse initial visual field defects (p < 0.0001) and worse visual acuity (p = 0.04) were associated with a faster resolution of ODE. Those treated with steroid therapy within 2 weeks after onset of NA-AION had significantly (p = 0.0006) faster ODE resolution than untreated cases. Severity of initial visual loss and systemic diseases were identical in steroid treated and untreated patients. A characteristic evolutionary pattern of ODE in NA-AION was observed. In conclusion, our study showed that in NA-AION the time course for resolution of ODE is shorter with greater severity of initial visual field and visual acuity loss, which may relate to the number of axons permanently damaged during the acute stage. Steroid therapy was associated with shorter time to resolution of ODE. Resolution of ODE goes through a characteristic evolutionary process. Supported by grant EY-1151 from the National Institutes of Health, Bethesda, Maryland, and in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York.     

Optic disc structure in anterior ischemic optic neuropathy

The etiology of anterior ischemic optic neuropathy (AION), when not associated with giant cell arteritis, is usually unknown. Clinical, pathologic, and experimental studies have not determined a cause. The optic disc appearance in both the involved and normal fellow eye was studied in 51 patients with acute nonarteritic AION. The number of discs (both involved and fellow) without a physiologic cup was significantly greater than would be expected from normal population studies. The etiology of nonarteritic AION may be related to the anatomic configuration of the optic nerve.     

非动脉炎性前部缺血性视神经病变的电生理及临床特征分析

目的：对NAION患者的电生理及临床特征进行分析。

方法：选取本院2015-06/2016-06收治的68例81眼非动脉炎性前部缺血性视神经病变(non-arteritic anterior ischaemic optic neuropathy,NAION)患者作为研究对象,按照年龄分为对照组36例39眼(平均年龄50岁以下),观察组32例42眼(平均年龄50岁以上)。对两组患者的人口学特点、临床特点、相关危险因素、图形视觉诱发电位、视力等方面进行对比分析。

结果：对照组患者临床症状中,发病时有遮挡感、对侧眼受累比例均明显低于观察组患者,组间差异有统计学意义(P<0.05)。对照组患者1°空间频率和15''空间频率均明显优于观察组,组间差异有统计学意义(P<0.05)。对照组与观察组患者初始视力比较,差异无统计学意义(P>0.05)。对照组患者最终视力明显优于观察组患者,组间差异有统计学意义(P<0.05)。

结论：患有NAION的患者,其临床病症受年龄较大、发病时有遮挡感、对侧眼受累等因素影响,1°空间频率和15''空间频率延迟相对较严重,且最终视力并不十分良好。由此可见,对NAION患者进行电生理检查有助于进行病情的诊断,临床亦应该加强对NAION患者的随访,减少其患眼对侧眼的发病几率。