逆行跨突触变性视神经病变的研究进展  

Advances in transsynaptic retrograde degeneration of optic neuropathy

作　　者：霍燕 蔺雪梅 吴松笛 Huo Yan;Lin Xuemei;Wu Songdi(Department of Neuro-Ophthalmology,The First Affiliated Hospital of Northwestern University(The First Hospital of Xi’an),Xi’an 710002,China)

机构地区：[1]西北大学附属第一医院(西安市第一医院)神经眼科,西安710002

出　　处：《中华眼底病杂志》2022年第12期1035-1038,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：陕西省科技计划项目(2022SF-381);陕西省卫健委科研项目(2022C005);陕西省中医药管理局项目(2022-SLRH-LJ-013)。

摘　　要：逆行跨突触变性视神经病变(TRDON)是指外侧膝状体及其后视觉通路受损引起突触前神经元(即视网膜神经节细胞)的变性和(或)凋亡。目前发现,TRDON病理基础是继发性视网膜神经节细胞P型β细胞的凋亡,导致出现与原发病引起的视野缺损相一致的视束萎缩和视网膜神经纤维层、视网膜神经节细胞层薄变以及视网膜微血管密度降低等表现,其中神经节细胞层薄变被认为是其特征性表现。目前国内对TRDON的认识及相关研究较少,临床医师可以通过光相干断层扫描进行观察,关注患者发生上述结构改变的特征和严重程度、发生时间及部位,监测病变的活动和进展,并将其作为药物干预的时间截点和开发新治疗方法的药物靶点,为患者恢复部分视功能,减轻残疾程度带来获益。Transsynaptic retrograde degeneration of optic neuropathy(TRDON)refers to the degeneration and/or apoptosis of presynaptic neurons(retinal ganglion cells)caused by damage to the lateral geniculate body and post-geniculate visual pathway.At present,the pathogenesis of TRDON is secondary apoptosis of Pβ-type retinal ganglion cells,resulting in the atrophy of optic tract,thinning of the retinal nerve fiber layer and retinal ganglion cell layer thickness and declining of retinal microvascular density,which are consistent with the visual field defect attributed to the primary disease.Of which,the thinning of the retinal ganglion cell layer thickness is considered as the characteristic of TRDON.Now,there is little understanding and related research on TRDON in China.Clinicians should pay attention to the characteristics and severity,occurrence time and location of the above structural changes in these patients through optical coherence tomography,and monitor the activity and progress of the lesions,so as to determine the cut-off point for drug intervention and the drug targets for developing new treatment methods,and bring benefits for patients in partial visual function recovery and disability reduction.

关 键 词：逆行跨突触变性视神经病变 视网膜神经节细胞 视野缺损 视束萎缩 综述 

分 类 号：R774.6[医药卫生—眼科]