视神经炎和前段缺血性视神经病变及视乳头水肿的视野改变分析

Visual field analysis in idiopathic demyelinating optic neuritis,non-arteritic anterior ischemic optic neuropathy and papillaedema

目的:比较特发性脱髓鞘性视神经炎(idiopathic demyelinating optic neuritis,IDON)、非动脉炎性前段缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy,NAION)和视乳头水肿(papilledema,PE)患者的视野变化特点,分析其发生机制。方法:回顾性病例研究。收集2011-03/2012-05期间在中国医科大学附属第四医院眼科诊治的IDON,NAION和PE患者的视野资料,记录患者的年龄、性别组成、最佳矫正视力(BCVA)、瞳孔大小、完成视野检测的时间、视野缺损的类型、部位、平均缺损(MD)和模式缺损(PSD)情况,SPSS 12.0统计软件包比较三组患者之间的差异。结果:IDON患者17例20眼,NAION患者21例26眼,PE患者11例22眼。三组患者平均年龄、性别比例、BCVA、瞳孔大小、完成视野检测的时间、视野MD和PSD的差异均具有统计学意义(P<0.05)。结论:IDON,NAION和PE患者的视野表现复杂多样,但又各有特点,这与三种疾病的发病机制密切相关,为视神经疾病的鉴别诊断提供依据。

AIM： To compare the visual field characteristics of patients with idiopathic demyelinating optic neuritis （IDON）, non-arteritic anterior ischemic optic neuropathy （NAION） and papilledema （ PE , and analyze their occurrence mechanism. METHODS： It was a retrospective case series study. Visual field data of patients with IDON, NAION, and PE who were treated in Department of Ophthalmology, the Fourth Affiliated Hospital, China Medical University from March 2011 to May 2012 were collected. Ages, gender, best-corrected visual acuities （BCVA）, pupil sizes, the visual field testing duration, types of visual field defect, the defect locations, mean deviation （MD） and pattern standard deviation （PSD） of the patients were compared and the reasons of these differences were analyzed by SPSS 12.0. RESULTS. There were 17 cases （20 eyes） with IDON, 21 cases （26 eyes） with NAION, 11 cases （22 eyes） with PE included in this study. All differences from mean age, gender composition, BCVA, pupil size, visual field testing duration, MD and PSD among three groups had statistical significance （P〈0.05）. CONCLUSION- Although these visual fields of patients with IDON, NAION and PE are complex, they have different features closely related with the pathogenesis of disease. These features can provide important evidence for differential diagnosis among optic nerve diseases.