前部缺血性视神经病变的临床分析

Clinical analysis of anterior ischemic optic neuropathy

目的:观察分析前部缺血性视神经病变(anterior ischemic optic neuropathy,AION)的发病危险因素、临床特征及治疗效果。方法:回顾性分析46例51眼AION患者全身及眼部危险因素、临床症状、眼底、FFA、视野改变。治疗和控制全身性疾病,全身或局部应用糖皮质激素、血管扩张剂、神经营养剂,评价治疗效果。结果:患者平均年龄53±10岁,全身性疾病包括高血压、糖尿病、高脂血症、低血压、心脑血管疾病等。47.06%患者诉视力突然下降,64.71%患者眼底检查示视盘呈灰白色水肿,33.33%患者视野表现偏盲性缺损,56.86%患者FFA早期视盘弱荧光,晚期荧光增强。经治疗80.39%患者视力提高,视野缺损改善。结论:AION是多病因眼病,高血压、糖尿病、高脂血症、心脑血管疾病等是其发生的危险因素。突然视力下降、视盘灰白水肿、偏盲性视野缺损、FFA视盘早期弱荧光、晚期强荧光是其典型表现。综合治疗后患者可恢复一定视力视野。

AIM：To observe and analyze the risk factors,clinical characteristics and treatment effect of anterior ischemic optic neuropathy（AION）.METHODS：Totally 46 cases（51 eyes） of anterior ischemic optic neuropathy were retrospectively analyzed with systemic and ocular risk factors,clinical symptoms,fundus,fundus flourescein angiography（FFA）,and visual field changes.To control systemic disease,systemic or topical corticosteroids,vasodilator and nerve nutrition agent were used.The therapeutic effects were evaluated.RESULTS：Patients had a mean age of 53±10 years,whose systemic diseases included hypertension,diabetes,hyperlipidemia,hypotension,cardiovascular and cerebrovascular diseases.47.06% patients reported sudden decrease in vision,64.71% patients with fundus examination showed optic disk gray edema,33.33% patients with visual field defects demonstrated hemianopia,56.82% patients with FFA showed early optic disc weak fluorescence,and advanced fluorescence enhancement.After treatment 80.39% patients improved the visual acuity and visual field.CONCLUSION：AION is a multifactor disease,hypertension,diabetes,hyperlipidemia,cardiovascular and cerebrovascular diseases are its risk factors.A sudden decline in vision,optic disc edema,hemianoptic visual field defects,optic disc early weak fluorescence and late strong fluorescence in FFA are the typical performances.Comprehensive treatment of patients can restore some vision and visual field.