国际眼科杂志
國際眼科雜誌
국제안과잡지
International Eye Science
2015年
9期
1500-1506
,共7页
廖良%韦企平%周剑%孙艳红%夏燕婷
廖良%韋企平%週劍%孫豔紅%夏燕婷
료량%위기평%주검%손염홍%하연정
临床特点%预后%非动脉炎性前部缺血性视神经病变
臨床特點%預後%非動脈炎性前部缺血性視神經病變
림상특점%예후%비동맥염성전부결혈성시신경병변
clinical characteristics%prognosis%nonarteritic ischemic optic neuropathy
目的：研究双眼非动脉炎性前部缺血性视神经病变(nonarteritic ischemic optic neuropathy, NAION)患者的临床特点及其预后的影响因素。<br> 方法：回顾2006年以来我院收治的双眼发病NAION患者的临床资料,包括发病特点、治疗方法、人口统计学特征、病史、视功能指标(视力、视野)等,并对影响视功能预后的相关因素进行统计分析。<br> 结果：研究共纳入61例(122眼)双眼NAION患者,其中男性39例,女性22例,平均年龄58.0依11.0岁,就诊时平均病程12.5mo(IQR 4.75~26.5),初诊时最佳矫正视力中位数为0.7 LogMAR(IQR 0.2~1.3)。就诊时38眼仍有不同程度视盘水肿,76眼视盘色淡或苍白。典型的视野缺损类型分别为下方近水平半盲(38眼)、鼻上方缺损(21眼)、鼻下方缺损(16眼)、上方近水平半盲(13眼),以及近管状视野(12眼)。纳入患者中31例伴有高血压、高血脂、糖尿病或其他心脑血管疾病。患者随访时间的中位数为12mo(IQR 6.0~23.5),随访期间视力中位数由0.7 LogMAR ( IQR 0.2~1.3)提高至0.4 LogMAR ( IQR 0.175~1.1),其中45眼(36.9%)的视力提高了2行或以上。男性患者和女性患者的视力比较,初诊时及随访后两者均无统计学差异(Z=-0.521,-1.600,P>0.05)。伴有心脑血管疾病的患者与不伴心脑血管疾病者比较,初诊时两组患者视力无统计学差异(Z=-1.103,P>0.05),但末次随访时不伴有心脑血管疾病的患者的视力明显优于伴心脑血管疾病的患者(Z=-2.090,P<0.05)。首发眼和后发病眼的末次随访视力均优于初诊视力( P=0.003, ；0.019),且首发眼的视力在随访期间的提高幅度高于后发病眼的视力提高幅度(分别为 0.2 LogMAR 及 0.1 LogMAR),但差异尚无统计学意义(P=0.195)。<br> 结论：本研究统计分析了双眼NAION患者的人口统计学特征、发病率、病史、视功能指标(视力、视野)等,现有随访数据表明,不伴心脑血管疾病的双眼NAION患者视力改善幅度优于患心脑血管疾病者,且首发眼视力预后可能优于后发病眼。但目前尚缺乏足够证据,仍需进一步研究。
目的：研究雙眼非動脈炎性前部缺血性視神經病變(nonarteritic ischemic optic neuropathy, NAION)患者的臨床特點及其預後的影響因素。<br> 方法：迴顧2006年以來我院收治的雙眼髮病NAION患者的臨床資料,包括髮病特點、治療方法、人口統計學特徵、病史、視功能指標(視力、視野)等,併對影響視功能預後的相關因素進行統計分析。<br> 結果：研究共納入61例(122眼)雙眼NAION患者,其中男性39例,女性22例,平均年齡58.0依11.0歲,就診時平均病程12.5mo(IQR 4.75~26.5),初診時最佳矯正視力中位數為0.7 LogMAR(IQR 0.2~1.3)。就診時38眼仍有不同程度視盤水腫,76眼視盤色淡或蒼白。典型的視野缺損類型分彆為下方近水平半盲(38眼)、鼻上方缺損(21眼)、鼻下方缺損(16眼)、上方近水平半盲(13眼),以及近管狀視野(12眼)。納入患者中31例伴有高血壓、高血脂、糖尿病或其他心腦血管疾病。患者隨訪時間的中位數為12mo(IQR 6.0~23.5),隨訪期間視力中位數由0.7 LogMAR ( IQR 0.2~1.3)提高至0.4 LogMAR ( IQR 0.175~1.1),其中45眼(36.9%)的視力提高瞭2行或以上。男性患者和女性患者的視力比較,初診時及隨訪後兩者均無統計學差異(Z=-0.521,-1.600,P>0.05)。伴有心腦血管疾病的患者與不伴心腦血管疾病者比較,初診時兩組患者視力無統計學差異(Z=-1.103,P>0.05),但末次隨訪時不伴有心腦血管疾病的患者的視力明顯優于伴心腦血管疾病的患者(Z=-2.090,P<0.05)。首髮眼和後髮病眼的末次隨訪視力均優于初診視力( P=0.003, ；0.019),且首髮眼的視力在隨訪期間的提高幅度高于後髮病眼的視力提高幅度(分彆為 0.2 LogMAR 及 0.1 LogMAR),但差異尚無統計學意義(P=0.195)。<br> 結論：本研究統計分析瞭雙眼NAION患者的人口統計學特徵、髮病率、病史、視功能指標(視力、視野)等,現有隨訪數據錶明,不伴心腦血管疾病的雙眼NAION患者視力改善幅度優于患心腦血管疾病者,且首髮眼視力預後可能優于後髮病眼。但目前尚缺乏足夠證據,仍需進一步研究。
목적：연구쌍안비동맥염성전부결혈성시신경병변(nonarteritic ischemic optic neuropathy, NAION)환자적림상특점급기예후적영향인소。<br> 방법：회고2006년이래아원수치적쌍안발병NAION환자적림상자료,포괄발병특점、치료방법、인구통계학특정、병사、시공능지표(시력、시야)등,병대영향시공능예후적상관인소진행통계분석。<br> 결과：연구공납입61례(122안)쌍안NAION환자,기중남성39례,녀성22례,평균년령58.0의11.0세,취진시평균병정12.5mo(IQR 4.75~26.5),초진시최가교정시력중위수위0.7 LogMAR(IQR 0.2~1.3)。취진시38안잉유불동정도시반수종,76안시반색담혹창백。전형적시야결손류형분별위하방근수평반맹(38안)、비상방결손(21안)、비하방결손(16안)、상방근수평반맹(13안),이급근관상시야(12안)。납입환자중31례반유고혈압、고혈지、당뇨병혹기타심뇌혈관질병。환자수방시간적중위수위12mo(IQR 6.0~23.5),수방기간시력중위수유0.7 LogMAR ( IQR 0.2~1.3)제고지0.4 LogMAR ( IQR 0.175~1.1),기중45안(36.9%)적시력제고료2행혹이상。남성환자화녀성환자적시력비교,초진시급수방후량자균무통계학차이(Z=-0.521,-1.600,P>0.05)。반유심뇌혈관질병적환자여불반심뇌혈관질병자비교,초진시량조환자시력무통계학차이(Z=-1.103,P>0.05),단말차수방시불반유심뇌혈관질병적환자적시력명현우우반심뇌혈관질병적환자(Z=-2.090,P<0.05)。수발안화후발병안적말차수방시력균우우초진시력( P=0.003, ；0.019),차수발안적시력재수방기간적제고폭도고우후발병안적시력제고폭도(분별위 0.2 LogMAR 급 0.1 LogMAR),단차이상무통계학의의(P=0.195)。<br> 결론：본연구통계분석료쌍안NAION환자적인구통계학특정、발병솔、병사、시공능지표(시력、시야)등,현유수방수거표명,불반심뇌혈관질병적쌍안NAION환자시력개선폭도우우환심뇌혈관질병자,차수발안시력예후가능우우후발병안。단목전상결핍족구증거,잉수진일보연구。
AIM: To evaluate the clinical characteristics of patients with bilateral nonarteritic ischemic optic neuropathy ( NAION) and the prognosis of NAION's impact factors.METHODS: NAION patients with both eyes onset from 2006 were included in this study, their clinical characteristics, treatment methods, the demographic index, medical history, visual acuity, visual field and other clinical data of NAION, including the impact factors of the prognosis, were obtained statistically. <br> RESULTS:A total of 61 patients ( 122 eyes ) have been diagnosed with NAION bilaterally, including 39 males and 22 females, with an average age of 58. 0±11. 0 years old, and the duration of the first onset was 12. 5mo (IQR 4. 75-26. 5). The median of the best log MAR corrected visual acuity of the 122 eyes at initial visit were 0. 7 logMAR (IQR 0. 2-1. 3), optic disc edema was seen in 38 eyes while optic disc saw in 76 eyes were pale or white. The most common types of visual field defects were inferior altitudinal visual field defect ( 38 eyes ) , supero-nasal defect (21 eyes), infero-nasal defect (16 eyes), superior altitudinal visual field defect (13 eyes), and tubular visual field defect (12 eyes). Among all the patients, there were 31 accompanied with hypertension, hyperlipidemia, diabetes, or a history of other cardiovascular and cerebrovascular diseases. After an median of 12mo (IQR 6-23. 5 ) of follow-up observation, the visual acuity has been increased from 0. 7 logMAR ( IQR 0. 2-1. 3 ) to 0. 4 logMAR (IQR 0. 175-1. 1), in which 45 eyes (36. 9%) increased 2 lines or more. Best corrected visual acuity (BCVA) had no significant differences (Z=-0.521,-1.600, P>0. 05) between the male and female patients at initial visit and during follow-up. BCVA of patients accompanied with cardiovascular or cerebrovascular disease had no significant differences (Z=-1. 103, P>0. 05) from those without cardiovascular or cerebrovascular disease before the treatment, while there were significant differences ( Z=-2. 090,P<0. 05) between the two type of patients at their last follow-up visit. The visual acuity of the earlier onset cases and the later onset cases were both significantly higher ( P= 0. 003, 0. 019 ) than that at last visit, while BCVA of earlier onset cases improved more than later onset cases ( median with 0. 2 and 0. 1 logMAR respectively, P=0. 195 ) though there was no significant differences. <br> CONCLUSION: After summarizing the demographic index, incidence, medical history, visual acuity, and visual field characteristics of the bilateral NAION patients, we found that patients who were accompanied with cardiovascular or cerebrovascular disease and the later onset eyes might had a poor prognosis than the others, though there were further evidence needed to support this finding.
