前部缺血性视神经病变的发生因素及诊断

PATHOGENIC FACTORS AND DIAGNOSIS OF ANTERIOR ISCHEMIC OPTIC NEUROPATHY

目的探讨前部缺血性视神经病变的发生因素及诊断。方法回顾性分析前部缺血性视神经病变 95例 (10 3只眼 )的发病特点 ,以及视野和眼底荧光素血管造影的表现。结果平均发病年龄 5 2 .4岁。 8例 (10只眼 )无原发病 ,87例 (93只眼 )伴有糖尿病、高血压和 (或 )眼底动脉硬化。眼底荧光素血管造影早期视盘全部或部分荧光充盈延缓或缺损 ,伴有相应的视野缺损。造影晚期视盘荧光形态有多种表现形式 ,缺血区呈强荧光者 76只眼(73 .79% ) ,呈弱荧光者 2 7只眼 (2 6 .2 1% )。结论中老年的糖尿病、高血压和 (或 )动脉硬化患者是前部缺血性视神经病变的高危人群 ,其诊断应综合考虑临床症状、视野和眼底荧光素血管造影检查结果。

ObjectiveTo investigate the pathogenic factors and the diagnosis of anterior ischemic optic neuropathy (AION).MethodsThe onset characteristic and the findings of visual field and fundus fluorescein angiography (FFA) of 103 eyes in 95 patients with AION were summarized retrospectively.ResultsThe average onset age was 52.4 years. No primary diseases were found in 8 patients (10 eyes) while 87 patients (93 eyes) were with diabetes mellitus, hypertension and/or fundus arteriosclrosis. At the early stage of FFA, all or a part of the optic disc had postponed or absent fluorescence filling with the corresponding visual field defects. At the late stage of FFA, the fluorescence of the optic disc varied in forms. At the ischemic area of the optic disc, high fluorescence was detected in 76 eyes( 73.79 %), and low fluorescence was detected in 27 eyes( 26.21 %).ConclusionThe middle and old age patients with diabetes mellitus, hypertension and/or fundus arteriosclrosis are high risk subjects for AION, and its diagnosis should depend on the comprehensive data analysis of clinical symptoms, FFA and visual fields.