缺血性视神经病变的研究进展  

Research advance of ischemic optic neuropathy

作　　者：林铁柱 沈丽君 Lin Tiezhu;Shen Lijun(Department of Ophthalmology,Zhejiang Provincial People's Hospital,Hangzhou 310014,Zhejiang Province,China)

机构地区：[1]浙江省人民医院眼科中心,中国浙江省杭州市310014

出　　处：《国际眼科杂志》2024年第9期1443-1447,共5页International Eye Science

基　　金：沈阳市中青年科技创新人才支持计划项目(No.RC210267);沈阳市卫健委科研课题计划(No.2022103)。

摘　　要：缺血性视神经病变(ION)是一种常见的中老年人致盲眼病。根据是否存在视盘水肿,ION可分为前部缺血性视神经病变(AION)和后部缺血性视神经病变(PION),其中AION更为常见(90%);根据是否患有血管炎,又可分为非动脉炎性ION和动脉炎性ION。几种类型ION的临床表现相似,但致病原因、治疗方法和预后却明显不同,动脉炎性ION可快速致盲、致残甚至致死。所以,对于ION,需早期识别是否伴有动脉炎,确定皮质类固醇药物使用的必要性。识别并尽可能控制ION潜在的可改变的危险因素对于防止患眼复发和对侧眼发作有一定的积极意义。文章就几种类型ION的病因、危险因素、诊断和管理做一综述,以期降低此类疾病的漏诊误治,改善其总体预后。Ischemic optic neuropathy(ION)is a common eye disease that could cause blindness.ION can be classified as anterior ischemic optic neuropathy(AION)or posterior ischemic optic neuropathy(PION)according to the presence or absence of optic disc edema.AION is more prevalent(90%).Moreover,ION can be divided into arteritic ION and non-arteritic ION based on the presence or absence of vasculitis.While various forms of ION may present comparable clinical symptoms,they differ considerably in terms of etiology,prognosis,and treatment approaches.Arteritic ION has the potential to cause blindness,disability,and even mortality in a short period of time.Therefore,early detection of arteritis and determination of the need for corticosteroid therapy are essential for the treatment of ION.The positive significance of identifying and managing potential modifiable risk factors for ION lies in its ability to prevent recurrence in both the affected and contralateral eyes.This article reviews the etiology,risk factors,diagnosis,and management of various varieties of ION with the goal of reducing misdiagnosis and improper treatment,thereby enhancing the overall prognosis of this condition.

关 键 词：缺血性视神经病变 前部缺血性视神经病变 后部缺血性视神经病变 巨细胞动脉炎 动脉炎性缺血性视神经病变 非动脉炎性缺血性视神经病变 

分 类 号：R774.6[医药卫生—眼科]