中华眼底病杂志

中华眼底病杂志

非动脉炎性前部缺血性视神经病变患眼脉络膜厚度研究

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目的 观察非动脉炎性前部缺血性视神经病变(NAION)患眼视盘周围脉络膜厚度(pCT)和黄斑中心凹下脉络膜厚度(SFCT)。 方法 临床检查确诊的单眼NAION患者44例44只眼(NAION组)和年龄、屈光程度匹配的健康志愿者60名60只眼(正常对照组)纳入研究。NAION组患者双眼根据患病与否,分为患眼组和对侧健康眼组,均为44例44只眼;根据患眼视盘水肿情况,分为视盘水肿期组和视盘水肿消退期组,分别为19例19只眼、25例25只眼。采用频域光相干断层扫描增强深度成像技术测量受检眼pCT和SFCT。采用双变量相关分析方法分析NAION患眼pCT、SFCT与视野平均缺损(MD)值、最佳矫正视力(BCVA)、视盘神经纤维层(RNFL)厚度的相关性。统计时将BCVA换算为最小分辨角对数(logMAR)视力。 结果 视盘水肿期组患眼鼻侧、鼻下以及颞下方的pCT较正常对照组受检眼显著增厚,差异有统计学意义(t=3.152、3.166、2.808,P<0.05)。视盘水肿消退期组患眼、对侧健康眼组受检眼pCT、SFCT与正常对照组受检眼比较,差异无统计学意义(P>0.05)。相关性分析结果显示,NAION患眼pCT(r=−0.220、−0.140、0.110)、SFCT(r=0.0957、−0.1483、−0.1312)与MD值、logMAR BCVA、视盘RNFL厚度之间无相关性(P>0.05) 结论 NAION患眼视盘水肿期部分象限pCT显著增厚;NAION患眼脉络膜厚度与年龄、屈光程度匹配的正常对照者无明显差异。

Objective To observe the peripapillary choroidal thicknesses (pCT) and subfoveal choroidal thicknesses (SFCT) of nonarteritic anterior ischemic optic neuropathy (NAION). Methods Forty-four Chinese patients with unilateral NAION were recruited and compared with 60 eyes of 60 normal age and refractive-error matched control subjects. pCT and SFCT were measured by enhanced depth imaging optical coherence tomography. Choroidal thicknesses of eyes with NAION and unaffected fellow eyes were compared with normal controls. Choroidal thicknesses of NAION eyes with or without optic disc edema were also compared. The correlation between choroidal thickness and retinal nerve fiber layer (RNFL) thickness, logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), and the mean deviation (MD) of Humphrey static perimetry in NAION eyes were analyzed. Results The pCT at the nasal, nasal inferior and temporal inferior quadrants in NAION eyes with optic disc edema were significantly thicker than that of normal subjects (t=3.152, 3.166, 2.808; P<0.05). There was no significant difference in the choroidal thicknesses between the unaffected fellow eyes of NAION patients and normal eyes of healthy controls; or between the NAION eyes with resolved optic disc edema and normal eyes (P>0.05). No significant correlation between choroidal thickness (r=-0.220, -0.140, 0.110), SFCT (r=0.096, -0.148, -0.131) and logMAR BCVA, perimetry MD and RNFL was found in eyes affected by NAION (P>0.05). Conclusions The peripapillary choroidal thicknesses increase in some quadrants in NAION eyes with optic disc edema. However, the choroidal thickness of NAION eyes is the same in age and refractive error-matched normal subjects.

关键词: 非动脉炎性前部缺血性视神经病变; 脉络膜厚度; 光学相干断层扫描

Key words: Non-arteritic anterior ischemic optic neuropathy; Choroidal thickness; Optical coherence tomography

引用本文: 姜利斌, 陈兰兰, 仇秀娟, 蒋冉, 王亚星, 徐亮, 赖旭佑. 非动脉炎性前部缺血性视神经病变患眼脉络膜厚度研究. 中华眼底病杂志, 2017, 33(5): 462-466. doi: 10.3760/cma.j.issn.1005-1015.2017.05.006 复制

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