中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2011年
2期
149-152
,共4页
杨晖%张秀兰%于强%钟毅敏%易长贤
楊暉%張秀蘭%于彊%鐘毅敏%易長賢
양휘%장수란%우강%종의민%역장현
视神经病变,缺血性/诊断%视野
視神經病變,缺血性/診斷%視野
시신경병변,결혈성/진단%시야
Optic neuropathy,ischemic/diagnosis%Visual fields
目的 观察分析非动脉炎性前部缺血性视神经病变(NAION)视野损伤特征及其影响因素.方法 确诊为NAION并有完整视野检查记录的139例患者纳入研究.其中,男性65例,占46.7%;女性74例,占53.3%.平均发病年龄(56.2±10.8)岁.所有患者均行视力、屈光状态、屈光间质检查,裂隙灯显微镜加前置镜眼底检查、眼底彩色照相、视野检查,其中125例患者进行了荧光素眼底血管造影(FFA)检查,同时行血压、实验室血常规及血生物化学检查.对所有患者的视野表现及其影响因素进行统计学分析;对77只眼的FFA检查结果与视野检查结果一致性进行对比分析.结果 视野检查结果显示,典型下半视野缺损者48只眼,占34.5%;弓形暗点者24只眼,占17.3%;不典型弓形暗点者24只眼,占17.3%;全视野缺损者20只眼,占14.4%;上半视野缺损者10只眼,占7.2%;上半视野缺损+下方弓形暗点者5只眼,占3.6%;下半视野缺损+上方弓形暗点者8只眼,占5.8%.患眼视野平均缺损值(MD值)为-3.0～-32.0,平均MD值为-17.9±7.9.77只眼中,FFA荧光缺损区与视野缺损区非常一致者7只眼,占9.1%;大部分一致者26只眼,占33.8%;小部分一致者39只眼,占50.6%;完全不一致者5只眼,占6.5%.多元线性回归分析结果显示,红细胞平均体积(MCV)(β=0.203,t=2.005)、胆固醇(CHOL)(β=0.230,t=2.244)是影响患眼视野MD值的因素(P＜0.05).结论 NAION视野损害呈现多样化表现;血MCV、CHOL可能是影响视野缺损程度的主要因素.
目的 觀察分析非動脈炎性前部缺血性視神經病變(NAION)視野損傷特徵及其影響因素.方法 確診為NAION併有完整視野檢查記錄的139例患者納入研究.其中,男性65例,佔46.7%;女性74例,佔53.3%.平均髮病年齡(56.2±10.8)歲.所有患者均行視力、屈光狀態、屈光間質檢查,裂隙燈顯微鏡加前置鏡眼底檢查、眼底綵色照相、視野檢查,其中125例患者進行瞭熒光素眼底血管造影(FFA)檢查,同時行血壓、實驗室血常規及血生物化學檢查.對所有患者的視野錶現及其影響因素進行統計學分析;對77隻眼的FFA檢查結果與視野檢查結果一緻性進行對比分析.結果 視野檢查結果顯示,典型下半視野缺損者48隻眼,佔34.5%;弓形暗點者24隻眼,佔17.3%;不典型弓形暗點者24隻眼,佔17.3%;全視野缺損者20隻眼,佔14.4%;上半視野缺損者10隻眼,佔7.2%;上半視野缺損+下方弓形暗點者5隻眼,佔3.6%;下半視野缺損+上方弓形暗點者8隻眼,佔5.8%.患眼視野平均缺損值(MD值)為-3.0～-32.0,平均MD值為-17.9±7.9.77隻眼中,FFA熒光缺損區與視野缺損區非常一緻者7隻眼,佔9.1%;大部分一緻者26隻眼,佔33.8%;小部分一緻者39隻眼,佔50.6%;完全不一緻者5隻眼,佔6.5%.多元線性迴歸分析結果顯示,紅細胞平均體積(MCV)(β=0.203,t=2.005)、膽固醇(CHOL)(β=0.230,t=2.244)是影響患眼視野MD值的因素(P＜0.05).結論 NAION視野損害呈現多樣化錶現;血MCV、CHOL可能是影響視野缺損程度的主要因素.
목적 관찰분석비동맥염성전부결혈성시신경병변(NAION)시야손상특정급기영향인소.방법 학진위NAION병유완정시야검사기록적139례환자납입연구.기중,남성65례,점46.7%;녀성74례,점53.3%.평균발병년령(56.2±10.8)세.소유환자균행시력、굴광상태、굴광간질검사,렬극등현미경가전치경안저검사、안저채색조상、시야검사,기중125례환자진행료형광소안저혈관조영(FFA)검사,동시행혈압、실험실혈상규급혈생물화학검사.대소유환자적시야표현급기영향인소진행통계학분석;대77지안적FFA검사결과여시야검사결과일치성진행대비분석.결과 시야검사결과현시,전형하반시야결손자48지안,점34.5%;궁형암점자24지안,점17.3%;불전형궁형암점자24지안,점17.3%;전시야결손자20지안,점14.4%;상반시야결손자10지안,점7.2%;상반시야결손+하방궁형암점자5지안,점3.6%;하반시야결손+상방궁형암점자8지안,점5.8%.환안시야평균결손치(MD치)위-3.0～-32.0,평균MD치위-17.9±7.9.77지안중,FFA형광결손구여시야결손구비상일치자7지안,점9.1%;대부분일치자26지안,점33.8%;소부분일치자39지안,점50.6%;완전불일치자5지안,점6.5%.다원선성회귀분석결과현시,홍세포평균체적(MCV)(β=0.203,t=2.005)、담고순(CHOL)(β=0.230,t=2.244)시영향환안시야MD치적인소(P＜0.05).결론 NAION시야손해정현다양화표현;혈MCV、CHOL가능시영향시야결손정도적주요인소.
Objective To study the visual field defects and its correlation factors in nonarteritic anterior ischemic optic neuropathy (NAION). Methods One hundred and thirty-nine patients of NAION with complete visual field examination results were included in this study. There were 65 males (46.7%)and 74 females (53.3%), with an average age of (56.2±10. 8) years. All the patients had undergone the examinations of visual acuity, refraction, refractive media, slit lamp ophthalmoscope, color fundus photography, visual field, blood pressure, blood routine test and blood biochemistry test. Fundus fluorescein angiography (FFA) was carried out in 125 patients. The visual field characteristics and its correlation factors were statistically analyzed, and the FFA and visual field results of 77 eyes were comparatively analyzed. Results The visual field examination showed typical inferior defect in 48 eyes (34. 5%), arcuate scotoma in 24 eyes (17.3%), atypical arcuate scotoma in 24 eyes (17. 3%), defuse defect in 20 eyes ( 14.4% ), superior defect in 10 eyes (7. 2 % ), superior defect with inferior arcuate scotoma in five eyes (3.6 %), inferior defect with superior arcuate scotoma in eight eyes (5.8%). The mean defect (MD) value ranged from -3.0 to -32.0,with an average of - 17.9±7.9. Among 77 eyes with FFA data,the FFA and visual field defect area were highly consistent seven eyes (9. 1%), consistent in 26 eyes (33.8%), some kind of consistent in 39 eyes (50. 6%), completely inconsistent in five eyes (6.5%).Multiple lineal regression analysis showed that mean red cell volume (MCV) (β=0. 203, t= 2. 005) and cholesterol level (CHOL) (β=0. 230, t=2. 244) were correlation factors of MD (P＜0. 05). Conclusion The visual field defect of NAION shows a variety of patterns which may be mainly influenced by MCV and CHOL.
