非动脉炎性前部缺血性视神经病变中黄斑区结构改变
发布时间：2018-11-28 14:28
【摘要】：目的:通过临床观察非动脉炎性前部缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy,NAION)急性期、1个月后、3个月后黄斑区总厚度(macular thickness,MT)、内层视网膜厚度(inner retinal complex,IRC)和外层视网膜厚度(outer retinal complex ORC)变化及与视野平均缺损(mean defect,MD)的关系进行研究分析,以便更加全面的了解NAION,为NAION疾病的发病机制探讨、诊断、防治提供更有价值信息和依据。此外,本文通过研究黄斑区脉络膜厚度(macular choroidal thickness,MCT)来探讨脉络膜厚度的改变与NAION的发病机制是否存在一定关系。方法1选取25例NAION患者,其中16例单眼患病,9例对侧眼曾患该病,刚患病25只眼为实验组,16只健康对侧眼为对照组,采用SD-OCT对两组黄斑区扫描,并在急性期进行最佳矫正视力、视野、荧光素眼底血管造影(fundus fluorescein angiography,FFA)、视觉诱发电位(visual evoked potential,VEP)等检查;并在1个月后及3个月后的随访时分别对其进行视野及双眼OCT扫描检查。分别观察在急性期、1个月和3个月时NAION患者MT、IRC及ORC的厚度变化及与视野MD的关系。方法2对已选取的25例NAION患者为实验组及在30例健康人中随机挑选出10例作为对照组,采用SD-OCT对患病1个月后的实验组及对照组进行黄斑区扫描。观察NAION和健康人MCT的变化。结果:1.在急性期MT(342.80±27.44μm,p≤0.001)、IRC(142.06±16.80μm,p=0,002)、ORC(200.36±14.7μm,p=0.006)厚度与对照组相比明显增厚,1个月后,MT(306.76±20.81μm,p=0.455)、IRC(121.00±14.68μm,p=0.426)、ORC(188.12±14.71μm,p=0.527)均数与急性期各层相比明显降低;3个月后MT(296.8±33.53μm,p=0.030)和IRC(114.96±18.02μm,p=0.030)厚度明显低于对照组,并且与1个月时各层视网膜厚度相比也明显降低。观察MT、IRC与ORC和视野MD的关系:在急性期、1个月和3个月时,MT与IRC和视野MD有明显的统计学关系;但ORC始终与MD不存在统计学差异。在急性期,MT与视野MD相关性最强(r=0.404,p=0.045);在疾病后期,IRC与视野MD的相关性高于MT与MD的关系(1个月r=0.803,p0.001;3个月r=0.855,p0.001)。2.观察NAION患者MCT(267.72±21.24μm,p≤0.001)与健康人(293±20.53μm)的厚度关系,发现NAION患者的MCT厚度明显比健康人薄。结论:在急性期,MT、ORC、IRC厚度明显比健康对侧眼厚;随着时间的推移,MT、IRC厚度处于变薄的状态,而ORC在疾病发展到一个月,即处于相对稳定状态;急性期到1个月时,各层网膜厚度下降最明显;MT及IRC与视野MD始终具有相关性,在急性期MT与视野MD相关性最大,而1个月和3个月后,IRC比MT对衡量视野MD的价值更高;NAION患者的MCT厚度明显比健康人薄。
[Abstract]:Objective: to observe the total macular thickness (macular thickness,MT) and inner retinal thickness (inner retinal complex,) of anterior ischemic optic neuropathy (non-arteritic anterior ischemic optic neuropathy,NAION) in the acute stage, 1 month and 3 months after non-arterial inflammation. IRC), (outer retinal complex ORC) changes of outer retinal thickness and their relationship with mean visual field defect (mean defect,MD) were analyzed in order to understand more comprehensively the pathogenesis and diagnosis of NAION disease. Prevention and cure provides more valuable information and basis. In addition, we studied the choroidal thickness of macular area (macular choroidal thickness,MCT) to explore whether the change of choroidal thickness is related to the pathogenesis of NAION. Methods 1 A total of 25 patients with NAION were selected, including 16 patients with monocular disease, 9 patients with contralateral eye who had the disease, 25 eyes were newly diagnosed as experimental group and 16 healthy contralateral eyes as control group. The macular area of both groups was scanned by SD-OCT. The best corrected visual acuity, visual field, fundus fluorescein angiography (fundus fluorescein angiography,FFA) and visual evoked potential (visual evoked potential,VEP) were examined in the acute phase. The visual field and binocular OCT were examined after 1 month and 3 months follow-up. The changes of MT,IRC and ORC thickness and the relationship between the thickness of MT,IRC and ORC and the visual field MD were observed in acute, 1 month and 3 month NAION patients respectively. Methods (2) Twenty five NAION patients were selected as experimental group and 10 healthy persons as control group. The macular area was scanned by SD-OCT in the experimental group and the control group after one month. The changes of NAION and MCT were observed. Results: 1. The thickness of MT in the acute phase (342.80 卤27.44 渭 m p 鈮，
本文编号：2363127
[Abstract]:Objective: to observe the total macular thickness (macular thickness,MT) and inner retinal thickness (inner retinal complex,) of anterior ischemic optic neuropathy (non-arteritic anterior ischemic optic neuropathy,NAION) in the acute stage, 1 month and 3 months after non-arterial inflammation. IRC), (outer retinal complex ORC) changes of outer retinal thickness and their relationship with mean visual field defect (mean defect,MD) were analyzed in order to understand more comprehensively the pathogenesis and diagnosis of NAION disease. Prevention and cure provides more valuable information and basis. In addition, we studied the choroidal thickness of macular area (macular choroidal thickness,MCT) to explore whether the change of choroidal thickness is related to the pathogenesis of NAION. Methods 1 A total of 25 patients with NAION were selected, including 16 patients with monocular disease, 9 patients with contralateral eye who had the disease, 25 eyes were newly diagnosed as experimental group and 16 healthy contralateral eyes as control group. The macular area of both groups was scanned by SD-OCT. The best corrected visual acuity, visual field, fundus fluorescein angiography (fundus fluorescein angiography,FFA) and visual evoked potential (visual evoked potential,VEP) were examined in the acute phase. The visual field and binocular OCT were examined after 1 month and 3 months follow-up. The changes of MT,IRC and ORC thickness and the relationship between the thickness of MT,IRC and ORC and the visual field MD were observed in acute, 1 month and 3 month NAION patients respectively. Methods (2) Twenty five NAION patients were selected as experimental group and 10 healthy persons as control group. The macular area was scanned by SD-OCT in the experimental group and the control group after one month. The changes of NAION and MCT were observed. Results: 1. The thickness of MT in the acute phase (342.80 卤27.44 渭 m p 鈮，
本文编号：2363127
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