前部缺血性视神经病变35例临床观察分析

An clinical analysis on 35 patients with anterior ischemic optic neuropathy

目的探讨眼底荧光血管造影（fundus fluorescence angiography，FFA）和视野检查对前部缺血性视神经病变（affterior ischemic optic neuropathy，AION）的诊断作用、治疗方法及预后情况。方法对35例（38眼）诊断为AION的FFA及视野图像进行分析，观察治疗前后的视力变化，视野及FFA改变。结果35例（38眼）AION患者，FFA检查均可见视盘区域性低荧光或充盈迟缓，同时伴有不同程度的视野缺损，经扩张血管改善循环，营养神经等治疗，65．7％的患者视力提高；68．4％患者视盘水肿减轻；77．7％患者视野不同程度改善；84．2％患者FFA显示视盘充盈时间提前，缺血范同缩小。结论AION应结合临床症状、眼底、视野及FFA检查结果做出正确诊断，及时系统治疗可挽救视力，纠正视神经缺血状况，改善视野。

Objective To explore the diagnostic roles of fundus fluorescein angiography （ FFA ） and visual field test for anterior ischemic optic, neuropathy （ AION ）, and the therapies and prognosis for AION. Methods The images of FFA and visual field test were analyzed in 35 patients with AION （ 38 eyes ）. The changes in visual acuity, visual field, and FFA findings were compared after treatment, Results FFA showed the appearance of local hypofluroescence and prolonged peffusion in the optic dise, with different degrees of visual field defects. After treatment with vasodilators and nerve nutrients, visual acuity was increased in 65.7% of the patients, optic dise; edema was relieved in 68.4%, visual field defect was improved in 77.7%, and time to perfusion of optic disc was shortened and isehemie size was lessened in 84.2%. Conclusions Anterior isehemie optic neuropathy can be diagnosed accurately by symptoms, fundoscopy, visual field test, and fundus fluorescein angiography. Proper treatment can save visual acuity and imporve optic nerve isehemia and visual field.