CAJ | 학술논문

目的追踪观察非动脉炎性前部缺血性视神经病变(NAION)水肿消退期后视盘颜色、中心视力、视野及盘周神经纤维(NFL)厚度的变化.方法对NAION水肿消退后的患者145例147只眼进行视盘颜色、中心视力、视野以及视盘周围NFL厚度的随访观察,按随访时间分组:6～12月内为A组147只眼、12～24月内为B组121只眼、24月以上为C组94只眼,对其结果进行统计分析.结果三组视盘颜色不同程度变化的分布比较无统计学意义(P＞0.05),颜色全部色淡呈完全萎缩性改变由A组的15.0％增加到C组(随访＞2年者)的18.1％.三组中心视力分布均差异无统计学意义(P＞0.05),视野改变比较差异有统计学意义(P＜0.05);视盘全周及各象限RNFL厚度A组均薄于正常人(P＜0.05),与随访前差异无统计学意义(P＞0.05),A组与B组差异无统计学意义(P＞0.05),C薄于B组差异有统计学意义(P＜0.05),鼻侧象限各组均差异无统计学意义(P＞0.05),颞、上、下象限C＜B＜A组(P＜0.05).结论 NAION水肿消退后随时间延续中心视力相对稳定,视野损伤加重,盘周RNFL厚度呈逐渐变薄趋势.
목적 추종관찰비동맥염성전부결혈성시신경병변(NAION)수종소퇴기후시반안색、중심시력、시야급반주신경섬유(NFL)후도적변화.방법 대NAION수종소퇴후적환자145례147지안진행시반안색、중심시력、시야이급시반주위NFL후도적수방관찰,안수방시간분조:6～12월내위A조147지안、12～24월내위B조121지안、24월이상위C조94지안,대기결과진행통계분석.결과 삼조시반안색불동정도변화적분포비교무통계학의의(P＞0.05),안색전부색담정완전위축성개변유A조적15.0％증가도C조(수방＞2년자)적18.1％.삼조중심시력분포균차이무통계학의의(P＞0.05),시야개변비교차이유통계학의의(P＜0.05);시반전주급각상한RNFL후도A조균박우정상인(P＜0.05),여수방전차이무통계학의의(P＞0.05),A조여B조차이무통계학의의(P＞0.05),C박우B조차이유통계학의의(P＜0.05),비측상한각조균차이무통계학의의(P＞0.05),섭、상、하상한C＜B＜A조(P＜0.05).결론 NAION수종소퇴후수시간연속중심시력상대은정,시야손상가중,반주RNFL후도정축점변박추세.
Objective To observe the changes of optic disc color and visual function and peripapillary retinal nerve fiber thickness in patients with nonarteritic anterior ischemic optic neuropathy (NAION) in long-time follow up.Methods A total of 145 cases 147 eyes had diagnosed as NAION at resolving stage,and followed up by visual acuity,visual field (Humphrey),the tomography of disc (Topcon 50EX fundus camera) and TOPCON OCT examination system at different period of follow up respectively.At 6-12 months of follow-up 147 eyes as group A,12-24 months 121 eyes as group B,and above 24 months 94 eyes as group C (a maximum of 60 months,an average of 34 months).Three stages of the observed results were analyzed.Results The results of three groups in optic disc color and visual acuity showed no significant difference each other (P＞0.05)and there were significant difference in visual field (P＜0.05).Comparison group A to normal control group in mean peripheral RNFL thickness and each quadrant RNFL thickness were statistical significance (P＜0.05),and showed no statistical significance contrast to that of the stage before follow up.Exception for nasal quadrant,other three quadrants comparison with groups showed that Group C was thinner than Group B,Group B was thinner than Group A.Conclusions In the long-time follow up of NAION after resolving period,the visual field defect become worse,while visual acuity is relative stable,and its peripapillary RNFL thickness show a declining trend.