非动脉炎性前部缺血性视神经病变视野表现分析

目的 观察分析非动脉炎性前部缺血性视神经病变(NAION)视野损伤特征及其影响因素.方法 确诊为NAION并有完整视野检查记录的139例患者纳入研究.其中,男性65例,占46.7%;女性74例,占53.3%.平均发病年龄(56.2±10.8)岁.所有患者均行视力、屈光状态、屈光间质检查,裂隙灯显微镜加前置镜眼底检查、眼底彩色照相、视野检查,其中125例患者进行了荧光素眼底血管造影(FFA)检查,同时行血压、实验室血常规及血生物化学检查.对所有患者的视野表现及其影响因素进行统计学分析;对77只眼的FFA检查结果与视野检查结果一致性进行对比分析.结果 视野检查结果显示,典型下半视野缺损者48只眼,占34.5%;弓形暗点者24只眼,占17.3%;不典型弓形暗点者24只眼,占17.3%;全视野缺损者20只眼,占14.4%;上半视野缺损者10只眼,占7.2%;上半视野缺损+下方弓形暗点者5只眼,占3.6%;下半视野缺损+上方弓形暗点者8只眼,占5.8%.患眼视野平均缺损值(MD值)为-3.0～-32.0,平均MD值为-17.9±7.9.77只眼中,FFA荧光缺损区与视野缺损区非常一致者7只眼,占9.1%;大部分一致者26只眼,占33.8%;小部分一致者39只眼,占50.6%;完全不一致者5只眼,占6.5%.多元线性回归分析结果显示,红细胞平均体积(MCV)(β=0.203,t=2.005)、胆固醇(CHOL)(β=0.230,t=2.244)是影响患眼视野MD值的因素(P＜0.05).结论 NAION视野损害呈现多样化表现;血MCV、CHOL可能是影响视野缺损程度的主要因素.

Abstract：

Objective To study the visual field defects and its correlation factors in nonarteritic anterior ischemic optic neuropathy (NAION). Methods One hundred and thirty-nine patients of NAION with complete visual field examination results were included in this study. There were 65 males (46.7%)and 74 females (53.3%), with an average age of (56.2±10. 8) years. All the patients had undergone the examinations of visual acuity, refraction, refractive media, slit lamp ophthalmoscope, color fundus photography, visual field, blood pressure, blood routine test and blood biochemistry test. Fundus fluorescein angiography (FFA) was carried out in 125 patients. The visual field characteristics and its correlation factors were statistically analyzed, and the FFA and visual field results of 77 eyes were comparatively analyzed. Results The visual field examination showed typical inferior defect in 48 eyes (34. 5%), arcuate scotoma in 24 eyes (17.3%), atypical arcuate scotoma in 24 eyes (17. 3%), defuse defect in 20 eyes ( 14.4% ), superior defect in 10 eyes (7. 2 % ), superior defect with inferior arcuate scotoma in five eyes (3.6 %), inferior defect with superior arcuate scotoma in eight eyes (5.8%). The mean defect (MD) value ranged from -3.0 to -32.0,with an average of - 17.9±7.9. Among 77 eyes with FFA data,the FFA and visual field defect area were highly consistent seven eyes (9. 1%), consistent in 26 eyes (33.8%), some kind of consistent in 39 eyes (50. 6%), completely inconsistent in five eyes (6.5%).Multiple lineal regression analysis showed that mean red cell volume (MCV) (β=0. 203, t= 2. 005) and cholesterol level (CHOL) (β=0. 230, t=2. 244) were correlation factors of MD (P＜0. 05). Conclusion The visual field defect of NAION shows a variety of patterns which may be mainly influenced by MCV and CHOL.

Analysis of visual field in nonarteritic anterior ischemic optic neuropathy

Objective To study the visual field defects and its correlation factors in nonarteritic anterior ischemic optic neuropathy (NAION). Methods One hundred and thirty-nine patients of NAION with complete visual field examination results were included in this study. There were 65 males (46.7%)and 74 females (53.3%), with an average age of (56.2±10. 8) years. All the patients had undergone the examinations of visual acuity, refraction, refractive media, slit lamp ophthalmoscope, color fundus photography, visual field, blood pressure, blood routine test and blood biochemistry test. Fundus fluorescein angiography (FFA) was carried out in 125 patients. The visual field characteristics and its correlation factors were statistically analyzed, and the FFA and visual field results of 77 eyes were comparatively analyzed. Results The visual field examination showed typical inferior defect in 48 eyes (34. 5%), arcuate scotoma in 24 eyes (17.3%), atypical arcuate scotoma in 24 eyes (17. 3%), defuse defect in 20 eyes ( 14.4% ), superior defect in 10 eyes (7. 2 % ), superior defect with inferior arcuate scotoma in five eyes (3.6 %), inferior defect with superior arcuate scotoma in eight eyes (5.8%). The mean defect (MD) value ranged from -3.0 to -32.0,with an average of - 17.9±7.9. Among 77 eyes with FFA data,the FFA and visual field defect area were highly consistent seven eyes (9. 1%), consistent in 26 eyes (33.8%), some kind of consistent in 39 eyes (50. 6%), completely inconsistent in five eyes (6.5%).Multiple lineal regression analysis showed that mean red cell volume (MCV) (β=0. 203, t= 2. 005) and cholesterol level (CHOL) (β=0. 230, t=2. 244) were correlation factors of MD (P＜0. 05). Conclusion The visual field defect of NAION shows a variety of patterns which may be mainly influenced by MCV and CHOL.