摘要
目的观察非动脉炎性前部缺血性视神经病变(nonarteritic anterior ischemic optic neuropathy,NAION)的眼底情况及荧光血管造影(fluorescein angiography,FAG)图像,分析不同阶段的病变特征。方法回顾性分析2012-2019年我科确诊的80例(113只眼)NAION患者,按发病时间分为A、B、C三组:A组(发病<1个月)30例36眼,B组(发病1~6个月)20例27眼,C组(发病>6个月)30例50眼,观察比较三组的眼底及FAG表现。结果A组中34眼(94.4%)眼底视盘水肿,27眼(75.0%)视盘周围出血;FAG主要表现为视盘早期荧光充盈缺损的分布与背景荧光不一致,呈现象限性强荧光分布,晚期26眼(72.2%)弥漫强荧光。B组15眼(55.5%)视盘水肿、盘周出血,FAG早期表现为视盘荧光象限分布。C组49眼(98.0%)视神经萎缩,46眼(92.0%)FAG早期视盘整体深层荧光充盈缺损,晚期持续低荧光。结论NAION早期主要表现为视盘水肿伴盘周出血渗出,视盘象限荧光分布;中期盘周出血渗出减少,开始出现视盘持续低荧光;晚期以视神经萎缩为主,FAG可见视网膜动静脉充盈改变。FAG可为该病的诊断、分期及鉴别提供有力的证据。
Objective To analyze fundus and fluorescein angiography(FAG)findings and characteristics of different stages of nonarteritic anterior ischemic optic neuropathy(NAION).Methods A retrospective analysis was performed in 80 patients(113 eyes)with clinically diagnosed non-arterial anterior ischemic optic neuropathy in our center from 2012 to 2019,and the patients were classified into group A(less than 1 month),B(1-6 months),and C(more than 6 months)according to the disease course.The fundus photography and fluorescence angiography images of the three groups were observed and compared.Results In group A,fundus photography showed 34 eyes(94.4%)had optic disc edema,27 eyes(75.0%)had hemorrhage around the optic disc;Fluorescence angiography showed 26 eyes(72.2%)had delayed optic disc filling,and hyperfluorescent staining in quadrant in early phase.In group B,15 eyes(55.5%)showed disc edema and hemorrhage around disc in fundus photography,and quadrant distribution of fluorescence in disc was found in early stage of FAG.In group C,49 eyes(98.0%)had optic nerve atrophy,and 46 eyes(92.0%)demonstrated deep-layer fluorescence filling defect of disc and persistent hypofluorescence in the late stage of FAG.Conclusion NAION mainlymanifests as optic disc edema accompanied by peripheral hemorrhage and exudation,and optic disc quadrant fluorescence distribution in early stage;decreased hemorrhage and exudation,and persistent hypofluorescencee of the optic disc in the intermediate stage;optic nerve atrophy,and changes in filling of retinal artery and vein in late stage.FAG can provide strong evidence for the diagnosis,staging and differentiation of NAION.
作者
李莹
石磊
贾亮
LI Ying;SHI Lei;JIA Liang(Department of Ophthalmology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《解放军医学院学报》
CAS
2020年第5期462-466,共5页
Academic Journal of Chinese PLA Medical School
关键词
非动脉炎性前部缺血性视神经病变
眼底照相
眼底荧光血管造影
神经眼科
视野缺失
nonarteritic anterior ischemic optic neuropathy
fundus photography
fundus fluorescein angiography
neuro-ophthalmology
visual field loss
