非动脉炎性前部缺血性视神经病变患者眼底病变与视力、视野的关系  

Relationship of Ocular Fundus Lesion with Visual Acuity and Visual Field in Patients with Nonarteritic Anterior Ischemic Optic Neuropathy

作　　者：洪薇薇 马鹤 单白洋 宋清雪 HONG Wei-wei;MA He;SHAN Bai-yang;SONG Qing-xue(Department of Ophthalmology,Liaoyang Central Hospital,Liaoyang,Liaoning 111000,China)

机构地区：[1]辽阳市中心医院眼科,辽宁辽阳111000

出　　处：《解放军医药杂志》2021年第2期79-83,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：辽宁省科学技术计划项目(2017241059)。

摘　　要：目的分析非动脉炎性前部缺血性视神经病变(NAION)患者视网膜厚度与视功能的相关性。方法选取2016年1月—2017年12月在我院就诊的NAION患者50例,将50只患眼作为观察组,对侧50只健眼作为对照组,观察2组视野、视力、光学相干断层图像(OCT)特征。结果与对照组比较,观察组视盘面积、视杯面积、杯盘面积比、视杯容积、视杯深度、最大视杯深度和视杯形态测量、视野敏感度均显著减少(P<0.05)。观察组视野平均缺损(MD)值明显高于对照组(P<0.05)。观察组确诊时视网膜神经纤维层厚度(RNFL)、外核层厚度(ONL)显著厚于对照组(P<0.05),但2组黄斑区神经节细胞层+内丛状层厚度(GCIP)、内核层厚度(INL)、外丛状层厚度(OPL)比较差异无统计学意义(P>0.05)。与确诊时相比,观察组治疗1个月后RNFL、ONL、GCIP和INL明显变薄(P<0.05)。观察组ONL与MD呈负相关(r=-0.453,P<0.05),RNFL与BCVA呈正相关(r=0.455,P<0.05)。观察组治疗1月后GCIP、ONL与MD有相关性(r=0.522、-0.442,P<0.05),且GCIP与同期的BCVA呈负相关(r=-0.460,P<0.05)。结论NAION不同时期视网膜各层厚度会出现不同变化,可能与患者视功能有一定关系。Objective To investigate correlation of retinal thickness with visual function in patients with nonarteritic anterior ischemic optic neuropathy(NAION).Methods We selected 50 NAION patients who treated in our hospital from January 2016 to December 2017.The sick eyes(n=50)were selected as observation group,while the contralateral eyes(n=50)were selected as control group.Visual field,visual acuity and characteristics of optical coherence tomography(OCT)images were observed in both groups.Results Compared with the control group,optic disc area,optic cup area,cup/disk area ratio,optic cup volume,average optic cup depth,maximum optic cup depth,cup shape measurement,and visual field sensitivity were significantly reduced in the observation group(P<0.05).The mean defect(MD)value was significantly higher in the observation group than in the control group(P<0.05).Rretinal nerve fiber layer(RNFL)thickness and outer nuclear layer thickness(ONL)thickness at diagnosis were significantly thicker in the observation group than in the control group(P<0.05),while there was no significant difference in the thickness of ganglion cell layer with the inner plexiform layer(GCIP),the inner nuclear layer(INL)and the outer plexiform layer(OPL)(P>0.05).At 1-month follow-up,the RNFL,ONL,GCIP and INL of the observation group were significantly thinner,as compared with those at diagnosis(P<0.05).In the observation group,ONL and MD were negatively correlated(r=-0.453,P<0.05),while RNFL and BCVA were positively correlated(r=0.455,P<0.05).At 1 month after treatment,the GCIP,ONL and MD were correlated(r=0.522,-0.442,P<0.05),and GCIP was negatively correlated with BCVA(r=-0.460,P<0.05).Conclusion At different stages of NAION,retinal thickness will be changed differently,which may have a certain relationship with visual function of the patient.

关 键 词：视神经病变 缺血性 视盘 视网膜厚度 视功能 视野 视力测定法 光学相干断层图像技术 

分 类 号：R774.6[医药卫生—眼科]