前部缺血性视神经病变临床检查及危险因素研究

发布时间：2018-04-17 04:07

本文选题：前部缺血性视神经病变 + 影响因素　；参考：《重庆医科大学》2011年硕士论文

【摘要】：目的探讨NAION的临床特征,探索其发病危险因素,从而为其早期诊断提供临床依据。方法收集2009年1月～2010年12月期间于我院住院并确诊为前部缺血性视神经病变的病例46例(52眼)的临床资料,分析其特点。纳入标准:病史、症状、眼底、视野、FFA结果均符合NAION的诊断标准,临床资料完整。排除标准:确诊或怀疑为巨细胞性动脉炎者。结果 46例中伴有高血压者21例,脑血管疾病15例,糖尿病14例,吸烟者14例,呈小视盘者3例,动脉硬化3例,白内障术后1例。44眼(84.62%)眼底出现视盘缺血性水肿,19眼(36.54%)视野表现为与生理盲点相连的暗点,FFA早期52眼(100%)表现为视盘全部或部分荧光充盈延迟或缺损,晚期表现各异,P-VEP P100波振幅降低潜伏期轻度延长,颈动脉彩超异常率较高但与NAION的发生无侧向一致性。结论非动脉炎性前部缺血性视神经病变是受多因素影响的眼部疾病,而高血压、糖尿病、脑血管疾病等是主要的危险因素,眼底、视野、FFA具有特征性的表现,即与视神经损害部位及范围相对应的视盘苍白区、视野缺损区及FFA荧光缺损或充盈延迟区域,P-VEP及颈动脉彩超在NAION患者中也有明显异常,但其特异性不高,可作为参考指标。充分了解患者局部及全身的危险因素,并将眼底、视野、FFA综合考虑并联合P-VEP及颈动脉彩超检查,对前部缺血性视神经病变的早期诊断具有重要价值。
[Abstract]:Purpose

To explore the clinical characteristics of NAION and explore the risk factors of NAION and provide clinical basis for early diagnosis of NAION .

method

The clinical data of 46 cases ( 52 eyes ) hospitalized in our hospital from January 2009 to December 2010 and diagnosed as anterior ischemic optic neuropathy were collected and their characteristics were analyzed .

Results

There were 21 cases of hypertension in 46 cases , 15 cases of cerebrovascular disease , 14 cases of diabetes mellitus , 14 cases of smokers , 3 cases with small visual disc , 3 cases of arteriosclerosis and 1 case of cataract .

Conclusion

Non - arteritic anterior ischemic optic neuropathy is an ocular disease affected by many factors , and hypertension , diabetes mellitus , cerebrovascular disease , etc . are the main risk factors , the fundus , the field of vision and FFA have the characteristic manifestation , that is , the visual disc paleness area , visual field defect area and FFA fluorescence defect or filling delay area , P - VEP and carotid color Doppler ultrasound in the area and scope of optic nerve damage are obviously abnormal , but their specificity is not high , can be used as the reference index . The comprehensive consideration of the local and systemic risk of the patient and the combination of P - VEP and carotid color Doppler ultrasound are fully understood , and the early diagnosis of the anterior ischemic optic neuropathy is valuable .

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R774.6

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