非动脉炎性前部缺血性视神经病变光相干断层扫描研究

The research of optical coherence tomography on non-arterior ischemic optic neuropathy

目的 探讨非动脉炎性前部缺血性视神经病变（non-arteritic anterior ischemic optic neuropathy,NAION）患眼远期视盘周围视网膜神经纤维层（retinal nerve fiber layer,RNFL）厚度及其与视野检查结果的相关性.方法 回顾性病例对照研究.对2007年8月至2009年8月在无锡市,第二人民医院眼科21例单眼发病NAION患者42只眼（21只发病眼为实验组,21只对侧正常眼为对照组）进行了视网膜神经纤维层厚度的光学相干断层扫描（optical coherence tomography,OCT）,并检查视野（visual field,VF）、图形视觉诱发电位（pattern-reversal visual evoked potential,P-VEP）等检查.结果 NAION患者RNFL厚度较对照组变薄,上半侧易受累,相应下方视野缺损多见,且视盘非病变区域的RNFL厚度也比正常对照组相应区域变薄.平均RNFL厚度与视野平均缺损有相关性（r=0.38,P ＜0.05）.结论 NAION患者远期盘周视神经纤维层厚度变薄,缺血区明显变薄,OCT检查非缺血区的RNFL厚度也变薄,提示NAION的RNFL丢失可能超过了视野检查的视野缺损的范围.NAION患眼盘周RNFL厚度与视野检查结果相关.

Objective To evaluate the thickness of peripapillary retinal nerve fiber layer in eyes with non-arteritic anterior ischemic optic neuropathy （NAION） and the correlation between retinal nerve fiber layer thickness with visual field detection. Methods Retrospective Case-control study.Participants：twenty-one patients diagnosed with NAION in our center between August 1 2007 and August 1 2009.Methods：Patients diagnosed with NAION were included to take optical coherence tomography scans of an area with a diameter of 3.46mm surrounding the disc and visual field and pattern-reversal visual evoked potential. Results The RNFL thickness of eyes with NAION was thinner than normal eyes,particularly in superior area,which corresponded to inferior altitudinal VF defects,and also in the unaffected area of NAION eyes.The mean RNFL thickness were correlated with visual field mean deviation （r=0.38,P 〈0.05）.OCT showed that NAION eyes had marked decreased RNFL thickness at the superior sectors.And the other area RNFL thickness （corresponding to the relative unaffected visual hemi-fi eld） also showed significantly statistics lower values in NAION eyes than in control eyes. Conclusions It suggests that loss of RNFL in NAION may extend beyond the region that corresponds to the VF defect as detected.The thickness of peripapillary retinal nerve fiber layer in eyes with NAION is correlated with the visual field results.