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黄斑微视野特征及其与视力和黄斑神经节细胞复合体的相关性分析

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目的 观察非动脉炎性前部缺血视神经病变(NAION)患眼黄斑微视野特征及其与视力和黄斑区神经节细胞复合体(GCC)的相关性。 方法 回顾性病例分析。临床检查确诊的NAION患者38例54只眼纳入研究。随机选取25例25只患眼、29例29只对侧正常眼分别作为病例组、对照组。所有受检眼均行最佳矫正视力(BCVA)、裂隙灯显微镜、间接检眼镜、眼底彩色照相、光相干断层扫描(OCT)、视野、微视野检查。BCVA统计时换算为最小分辨角对数(logMAR)视力。病例组、对照组患者年龄(t=−0.647)、性别构成比、眼别(χ2=0.128、0.099)、眼压(t=0.376)比较,差异均无统计学意义(P>0.05)。采用OCT仪测量黄斑区GCC和上下方GCC厚度。扫描时同时获取GCC整体丢失体积(GLV)与局部丢失体积(FLV)。采用黄斑完整性评估仪行微视野检查。记录受检眼黄斑10°区域平均光敏感度(MS)、黄斑中心凹2°和4°固视率。采用Spearman相关分析MS与黄斑区GCC、BCVA的相关性。 结果 病例组、对照组受检眼平均logMAR BCVA分别为0.68±0.79、0.07±0.06。两组受检眼MS比较,差异有统计学意义(t=−2.507,P=0.037);平均GCC(t=−1.245,P=0.259)、上下方GCC(t=−1.336、−1.024,P=0.230、0.346)、FLV(t=1.058,P=0.331)、GLV(P=0.182)比较,差异均无统计学意义。相关性分析结果显示,BCVA与MS有显著相关性(r=−0.809,P=−0.005);与GCC、上下GCC、FLV、GLV无相关性(r=−0.98、−0.466、−0.061、0.442、0.442,P=0.817、−0.244、0.885、0.273、0.273)。MS与GCC、上下GCC、FLV、GLV无相关性(r=0.238、0.524、0.286、0.643、−0.619,P=0.570、0.183、0.493、0.086、0.102)。 结论 早期NAION患眼MS降低;与黄斑区GCC无相关。

Objective To observe the characteristics of multifocal microperimetry and its relationship with visual acuity and multifocal ganglion cell complex (GCC) in nonarteritic anterior ischemic optic neuropathy (NAION). Methods A retrospective case study. A total of 38 patients (54 eyes) with NAION were enrolled in this study. 25 NAION eyes (25 patients) and 29 contralateral health eyes (29 patients) were randomly selected into case group and control group respectively. All eyes underwent best corrected visual acuity (BCVA), slit lamp microscope, indirect ophthalmoscope, color fundus photography, optical coherence tomography (OCT), visual field and multifocal microperimetry. Logarithm of the minimum angle of resolution (logMAR) was used to calculate BCVA. There were no significantly differences on age (t=−0.647), gender, dominant eyes ( χ2=0.128, 0.099), intraocular pressure (t=0.376) between two groups (P>0.05). Macular GCC thickness, superior and inferior GCC thickness were measured by OCT, focal loss volume (FLV) and global loss volume (GLV) were obtained at the same time. Microperimetry were measured by macular integrity assessment instrument (MAIA microperimetry), and mean retinal sensitivities (MS) in macular area 10° and fixation rate in the macular central 2° and 4° were determined. The relationship between MS, macular GCC and BCVA were analyzed by Spearman correlation analysis. Results The mean logMAR BCVA of case group and control group were 0.68±0.79 and 0.07±0.06, respectively. There was significantly statistical difference in MS between two groups (t=−2.507, P=0.037). There were no significantly statistical difference in mean GCC (t=−1.245, P=0.259), superior and inferior GCC (t=−1.336, −1.024; P=0.230, 0.346), FLV (t=1.058, P=0.331) and GLV (P=0.182) between two groups. The correlation between BCVA and MS (r=−0.809, P=−0.005) was observed. However, there were no correlation between BCVA and GCC, superior and inferior GCC, FLV, GLV (r=−0.98, −0.466, −0.061, 0.442, 0.442; P=0.817, −0.244, 0.885, 0.273, 0.273). And also, there were no correlation between MS and GCC, superior and inferior GCC, FLV, GLV (r=0.238, 0.524, 0.286, 0.643, −0.619; P=0.570, 0.183, 0.493, 0.086, 0.102). Conclusions MS reduced in early stage NAION eyes, which did not correlate with macular GCC.

关键词: 视神经病变,缺血性; 视野; 体层摄影术,光学相干

Key words: Optic neuropathy, ischemic; Visual fields; Tomography, optical coherence

引用本文: 巩鸿霞, 王兰惠. 非动脉炎性前部缺血性视神经病变黄斑微视野特征及其与视力和黄斑神经节细胞复合体的相关性分析. 中华眼底病杂志, 2018, 34(1): 34-37. doi: 10.3760/cma.j.issn.1005-1015.2018.01.009 复制

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