先天性视盘占位病变继发非动脉炎性前部缺血性视神经病变的临床特征分析  

Clinical characteristics of non-arteritic anterior ischemic optic neuropathy associated with congenital occupying lesions in optic disc

作　　者：乌日汗 刘丽娟 杨本涛[2] 姜利斌 Wu Rihan;Liu Lijuan;Yang Bentao;Jiang Libin(Beijing Tongren Eye Center,Beijing Tongren Hospital,Beijing Institute of Ophthalmology,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing 100730,China;Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,北京市眼科研究所,眼科学与视觉科学北京市重点实验室,100730 [2]首都医科大学附属北京同仁医院放射科,100730

出　　处：《眼科》2020年第2期141-146,共6页Ophthalmology in China

基　　金：国家自然科学基金(81570836)。

摘　　要：目的探讨先天性视盘占位病变相关的非动脉炎性前部缺血性视神经病变(NAION)的临床特征。设计回顾性病例系列。研究对象2010年1月-2019年6月北京同仁医院先天性视盘占位病变继发NAION患者9例(11眼)。方法回顾及分析患者的眼科及头颅神经影像学资料。所有患者均经半年以上随访。主要指标性别、年龄、发病眼别、视盘病变特征及与视野改变关系、头颅神经影像学表现。结果9例继发NAION的先天性视盘占位病变中4例视盘黑色素细胞瘤,3例视盘内玻璃膜疣,2例视盘区残存有髓纤维。年龄26~65岁(中位数39岁)。7例单眼发生NAION,2例视盘内玻璃膜疣患者双眼先后发生NAION。发生NAION时患眼矫正视力0.05~1.0。可行视野检查的4例患者表现为水平下半缺损及向心性缩小。最后随访时均无视功能进行性损伤和病情复发。结论先天性视盘占位性病变可继发NAION而出现视功能损伤。Objective To summarize the clinical characteristics of non-arteritic anterior ischemic optic neuropathy(NAION)associated with congenital occupying lesions in optic disc.Design Retrospective case series.Participants A total of 9 rare cases(11 eyes)with NAION associated with congenital optic disc occupying lesions,in Beijing Tongren Hospital between January 2010 and June 2019 were collected.Methods Ophthalmic and cranial neuroimaging data of patients were reviewed.All patients were followed up for at least 6-mouths.Main Outcome Measures Age,the effected single/both eyes,visual field defect,neuroradiology data.Results There were 4 cases of melanocytoma,3 cases of drusen and 2 cases of myelinated nerve fiber which were associated with NAION in this study.The median age of disease occurred were 39 years old(range:26-65 years).Involvement of monocular congenital optic disc occupying lesion was happened in all patients of melanocytoma and myelinated nerve fiber which were also suffered from unilateral NAION at the same eye.However,the opposite situation occurred in 3 patients of drusen,whose lesions were all bilateral but 2 patients were suffered from NAION in both eyes successively.The best corrective visual acuity variation of 11 eyes was 0.05 to 1.0 and automated static perimetry was presented with horizonal inferior depression and concentric defection in 4 patients.The deterioration of visual function and the reoccurrence of disease were never happened in all patients on last follow-up.Conclusions Some congenital optic disc occupying lesions could suffer severe visual dysfunction on account of the occurrence of NAION.

关 键 词：视盘 黑色素细胞瘤 玻璃膜疣 有髓纤维 非动脉炎性前部缺血性视神经病变 

分 类 号：R774.6[医药卫生—眼科]