光学相干断层扫描技术在前部缺血性视神经病变不同病程中的应用

发布时间：2018-10-15 07:44

【摘要】：目的探讨前部缺血性视神经病变(AION)视盘周围视网膜神经纤维层(RNFL)厚度与病程发展之间的关系。方法回顾性临床研究。2011年1月—2015年1月北京中医药大学第二附属医院东方医院门诊确诊AION,并行频域光学相干断层扫描(FD-OCT)检查视盘周围RNFL厚度的患者45例(54只眼),年龄(58.41±10.33)岁;双眼发病9例,单眼发病36例;不伴全身性疾病者10例,伴有全身性疾病者35例;屈光度-4.00 D~+4.00 D;随访资料最大病程365 d。选取年龄匹配、无眼部疾病的健康志愿者31例(62只眼)的RNFL厚度结果作为正常对照。分析AION眼不同病程阶段的RNFL厚度变化;比较单眼AION患者患眼及对侧健眼的RNFL厚度差异;以不合并全身性疾病AION患者为参照,分析全身性疾病对AION患眼RNFL厚度的影响。结果 AION发病后1~10 d内平均RNFL厚度增厚,在11~20 d达最高峰;在21~30 d、31~40 d开始下降,水肿消退;41~90 d RNFL开始发生薄变;在91~365 d显著薄变;365 d后,薄变程度趋于稳定。在各个象限中,下方象限水肿最严重;鼻侧、颞侧象限最先受损。单眼AION患眼相对对侧健眼的RNFL厚度变化情况大致相同。合并全身性疾病AION眼的早期盘周RNFL增厚及晚期RNFL薄变均较不伴全身性疾病者明显。结论 AION盘周RNFL厚度存在早期增厚,中晚期变薄的特点。利用OCT测量RNFL厚度,是监测AION疾病发展过程的有效手段。
[Abstract]:Objective to investigate the relationship between the thickness of retinal nerve fiber layer (RNFL) and the development of anterior ischemic optic neuropathy (AION). Methods from January 2011 to January 2015, 45 patients (54 eyes) with AION, and frequency domain optical coherence tomography (FD-OCT) were diagnosed as patients (58.41 卤10.33 years), aged (58.41 卤10.33), in Dongfang Hospital, second affiliated Hospital of Beijing University of traditional Chinese Medicine. There were 9 cases of binocular disease, 36 cases of monocular disease, 10 cases without systemic disease, 35 cases with systemic disease, -4.00 D ~ 4.00 D, followed up for 365 days. The RNFL thickness of 31 healthy volunteers (62 eyes) with age matched and no eye disease was used as normal control. To analyze the changes of RNFL thickness in different stages of AION eyes, to compare the difference of RNFL thickness between monocular AION patients and contralateral healthy eyes, and to analyze the effect of systemic diseases on RNFL thickness of AION eyes. Results the average thickness of RNFL increased within 10 days after onset of AION, reached its peak at 1120 days, began to decrease and edema subsided at 2130 days and 31 days after onset, RNFL began to thinning on day 41 to 90, significantly thin on day 91 to 365, and the degree of thin change tended to be stable after 365 days. In each quadrant, the edema in the lower quadrant is the most serious, and the nasal and temporal quadrants are the first to be damaged. The change of RNFL thickness in monocular AION patients was approximately the same as that in contralateral healthy eyes. The early peripheral RNFL thickening and late RNFL thinning in AION eyes with systemic disease were more obvious than those without systemic disease. Conclusion the thickness of peridisc RNFL in AION has the characteristics of early thickening and late thinning. Using OCT to measure the thickness of RNFL is an effective method to monitor the development of AION disease.
【作者单位】：北京中医药大学;北京中医药大学第二附属医院东方医院;北京中医药大学第三附属医院;
【基金】：国家自然科学基金面上项目(81173307)
【分类号】：R774.6

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