外伤性视神经萎缩光相干断层成像表现及视功能损害

Image of the Traumatic Optic Atrophy Detected with Optical Coherence Tomography and the Vision Function Defection

目的分析单侧外伤性视神经萎缩的光相干断层成像(optical coherence tomography,OCT)表现并探求其与视力、视野损害的关系。方法对15例外伤性视神经萎缩的法医学鉴定案例进行研究,所有案例均进行眼科常规检查、视觉电生理检查及视盘OCT检查,视力大于0.1者进行视野检查。结果15例视神经损伤者均有不同程度的视力、视野等视功能损害及视盘视网膜神经纤维层萎缩。结论外伤性视神经萎缩多始自视盘颞侧,鼻侧萎缩发生最晚且最轻;视神经萎缩程度越重,相应的视功能损害也越重;OCT技术对评价视神经萎缩有重要的意义,与视功能损害也有较好的吻合性。

Objective To analyze the unilateral image of the traumatic optic nerve atrophy using optical coherence tomography（OCT） and to explore the relationship between the optic nerve atrophy and visual acuity or visual field. Methods Fifteen cases with traumatic optic nerve atrophy were studied. All cases were tested by routine opthalmological examination, visual evoked potentials（VEP） and optic disc examination with OCT. In cases with visual acuity more than 0.1 the visual field was tested. Results All cases had visual acuity and visual field defect at various levels and optic disc retinal nerve fiber layer （RNFL） atrophy. Conclusion The traumatic optic atrophy begins in the temporal area of optic disc. The nasal area＇s atrophy occurs at the last and is the mildest. The more serious is the optic nerve atrophy, the worse is the vision function impairment. OCT is a valuable technique for evaluating the optic nerve atrophy and has good correlation with the visual function.