195例视盘水肿患者的病因分析  

Etiological analysis of 195 cases with optic disc swelling

作　　者：李猛 张熙芳 刘丽娟 王鑫 闫玮玉 Li Meng;Zhang Xifang;Liu Lijuan;Wang Xin;Yan Weiyu(Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing Tongren Hospital,Capital Medical University,Beijing 100005,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,100005

出　　处：《眼科》2020年第6期460-464,共5页Ophthalmology in China

摘　　要：目的分析北京同仁眼科中心神经眼科门诊就诊的视盘水肿患者的病因。设计回顾性病例系列。研究对象2018年1月至12月在北京同仁眼科中心神经眼科门诊就诊的195例视盘水肿患者。方法回顾性分析了195例视盘水肿患者的电子病历资料。对全部、不同年龄组和单双眼视盘水肿的病因分布进行分析,并对视盘水肿排名前两位的病种进行临床特征对比分析。主要指标病因分布构成比。结果非动脉炎性前部缺血性视神经病变(NA-AION)是视盘水肿最常见的病因(49.7%),后面依次是视神经炎(16.4%)、颅内压增高所致视乳头水肿(7.7%)。≤20岁组,视盘水肿最常见的病因是假性视乳头水肿,>20且≤50岁组和>50岁组,视盘水肿的最常见病因均是NA-AION。单眼视盘水肿的最常见病因是NA-AION,双眼最常见的是颅内压增高所致视乳头水肿。与视神经炎相比,NA-AION的年龄更大,单眼水肿更常见,主诉视野遮挡更多,较少伴有眼痛。结论神经眼科门诊最常见的视盘水肿病因是NA-AION,其次是视神经炎。发病年龄和发病眼别(单眼或双眼)对于我们寻找视盘水肿的病因具有一定的提示作用。Objective To investigate the etiologies of optic disc swelling among patients presenting to Department of Neuro-ophthalmology,Beijing Tongren Eye Center.Design Retrospective case series.Participants 195 cases with optic disc swelling presenting to the Department of Neuro-ophthalmology,Beijing Tongren Eye Center from January to December 2018.Methods The electronic medical records of 195 patients with optic disc swelling were analyzed retrospectively.The etiologies of optic disc swelling in all patients,different age groups,unilateral or bilateral optic disc swelling groups were analyzed.A comparative analysis was made on the top two etiologies of optic disc swelling.Main Outcome Measures Constituent ratio of etiology.Results Non-arteritic anterior ischemic optic neuropathy(NA-AION) is the most common cause of optic disc swelling(49.7%),followed by optic neuritis(16.4%) and papilledema(7.7%).The etiology of optic dise swelling was different in different age groups.The most common cause of optic disc edema was pseudopapilledema in the≤20 years group.NA-AION in the>20 but≤50 years group and> 50 years group.NA-AION is the most common cause of unilateral optic disc swelling,and papilledema is the most common cause of bilateral optic disc swelling.Compared with optic neuritis group,the age is older,unilateral swelling is more common,visual field defect is more,and ocular pain is less in NA-AION group.Conclusion NA-AION is the most common cause of optic disc swelling in neuro-ophthalmology clinic,followed by optic neuritis.The age of onset and the side of eye(unilateral or bilateral) are helpful for us to discriminate the etiologies of optic disc swelling.

关 键 词：视盘水肿 非动脉炎性前部缺血性视神经病变 视神经炎 视乳头水肿 

分 类 号：R774.6[医药卫生—眼科]