摘要
目的 了解前部缺血性视神经病变神经纤维束损害的后期动态变化及其对视功能的影响，确认实施神经保护治疗的临床意义。方法对临床诊断为前部缺血性视神经病变患者96例（128只眼），经急性期治疗病情基本稳定后转入随访观察，每3-6个月随诊一次，一年后每年随诊一次，每次作眼底、视力、视野及视盘周神经纤维层厚度OCT检查。对随诊检测数值进行统计分析并作比较性研究。结果（1）全部病例均经6～12个月的随诊，达1-2年者72例，〉2—4年者47例，4年以上36例。（2）随诊期内原视神经萎缩及眼底情况无明显改变，有8例在之后另眼发生不同程度的前部缺血性视神经病变（8．7％）。（3）随诊期内在排除屈光及其他因素外，视力变化差异无统计学意义。（4）随诊期内视野损害的形态位置无明显变化，而视野敏感度有所下降。（5）随诊期内初次视盘区OCT检查与以后各次相比视盘周神经纤维的厚度有不同程度的变薄。（6）随诊期内接受神经保护治疗者盘周神经纤维层的厚度及视野敏感度优于未接受治疗者。结论前部缺血性视神经病变后期神经纤维束仍处于缓慢受损状态，探讨受损机制，实施神经保护治疗的措施仍是必要的。
Objective To investigate the dynamics damage of the nerve fiber bundle and its effects on visual function in late phage of anterior ischemic optic neuropathy （A/ON）, and confirm the clinical significance of taking further neuroprotective treatment. Methods Ninety-six patients （128 eyes） clinical diagnosed of anterior ischemic optic neuroipathy, through acute phage treatment and after becoming stable, were followed every 3-6 months and then every year one year later. For every followed time, the fundus, vision and visual field were examined and the thickness of nerve fiber layer was measured by OCT. The data were statistically analyzed and comparatively studied. Results （1） All patients were followed for 6-12 months, among them 72 cases were followed between 1 to 2 years, 47 cases between 2 to 4 years, and 36 cases over 4 years. （2） There was no significant change of the optic atrophy and fundus during the followed time, 8 cases （8.7%） developed anterior ischemic optic neuropathy in the fellow eye. （3） Exclude of the refraction and the other factors, there were no significant difference in visual acuity. （4） There was no significant change of the location and the form of visual field damage during the followed time, however the sensitivity decreased. （5） Compared to the first OCT inspection, the subsequent OCT inspection showed that the optic disc peripheral nerve fibers became thinner to different degree during the followed time. （6） During the followed time, the periph- eral nerve fiber layer thickness and visual field sensitivity of the patients treated by the neuroprotective were better than those not treated. Conclusions In the late phage of NAION, the nerve fiber bundle are still damaged slowly. It is necessary to investigate the damage mechanism and take the neuroprotective treatment.
出处
《中国实用眼科杂志》
CSCD
北大核心
2011年第12期1255-1257,共3页
Chinese Journal of Practical Ophthalmology
关键词
缺血性视神经病变
视神经纤维
Anterior Ischemic Optic Neuropathy
Optic nerve fiber
