【摘要】：目的:通過臨床觀察非動脈炎性前部缺血性視神經(jīng)病變(non-arteritic anterior ischemic optic neuropathy,NAION)急性期、1個月后、3個月后黃斑區(qū)總厚度(macular thickness,MT)、內(nèi)層視網(wǎng)膜厚度(inner retinal complex,IRC)和外層視網(wǎng)膜厚度(outer retinal complex ORC)變化及與視野平均缺損(mean defect,MD)的關(guān)系進(jìn)行研究分析,以便更加全面的了解NAION,為NAION疾病的發(fā)病機制探討、診斷、防治提供更有價值信息和依據(jù)。此外,本文通過研究黃斑區(qū)脈絡(luò)膜厚度(macular choroidal thickness,MCT)來探討脈絡(luò)膜厚度的改變與NAION的發(fā)病機制是否存在一定關(guān)系。方法1選取25例NAION患者,其中16例單眼患病,9例對側(cè)眼曾患該病,剛患病25只眼為實驗組,16只健康對側(cè)眼為對照組,采用SD-OCT對兩組黃斑區(qū)掃描,并在急性期進(jìn)行最佳矯正視力、視野、熒光素眼底血管造影(fundus fluorescein angiography,FFA)、視覺誘發(fā)電位(visual evoked potential,VEP)等檢查;并在1個月后及3個月后的隨訪時分別對其進(jìn)行視野及雙眼OCT掃描檢查。分別觀察在急性期、1個月和3個月時NAION患者M(jìn)T、IRC及ORC的厚度變化及與視野MD的關(guān)系。方法2對已選取的25例NAION患者為實驗組及在30例健康人中隨機挑選出10例作為對照組,采用SD-OCT對患病1個月后的實驗組及對照組進(jìn)行黃斑區(qū)掃描。觀察NAION和健康人MCT的變化。結(jié)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)厚度與對照組相比明顯增厚,1個月后,MT(306.76±20.81μm,p=0.455)、IRC(121.00±14.68μm,p=0.426)、ORC(188.12±14.71μm,p=0.527)均數(shù)與急性期各層相比明顯降低;3個月后MT(296.8±33.53μm,p=0.030)和IRC(114.96±18.02μm,p=0.030)厚度明顯低于對照組,并且與1個月時各層視網(wǎng)膜厚度相比也明顯降低。觀察MT、IRC與ORC和視野MD的關(guān)系:在急性期、1個月和3個月時,MT與IRC和視野MD有明顯的統(tǒng)計學(xué)關(guān)系;但ORC始終與MD不存在統(tǒng)計學(xué)差異。在急性期,MT與視野MD相關(guān)性最強(r=0.404,p=0.045);在疾病后期,IRC與視野MD的相關(guān)性高于MT與MD的關(guān)系(1個月r=0.803,p0.001;3個月r=0.855,p0.001)。2.觀察NAION患者M(jìn)CT(267.72±21.24μm,p≤0.001)與健康人(293±20.53μm)的厚度關(guān)系,發(fā)現(xiàn)NAION患者的MCT厚度明顯比健康人薄。結(jié)論:在急性期,MT、ORC、IRC厚度明顯比健康對側(cè)眼厚;隨著時間的推移,MT、IRC厚度處于變薄的狀態(tài),而ORC在疾病發(fā)展到一個月,即處于相對穩(wěn)定狀態(tài);急性期到1個月時,各層網(wǎng)膜厚度下降最明顯;MT及IRC與視野MD始終具有相關(guān)性,在急性期MT與視野MD相關(guān)性最大,而1個月和3個月后,IRC比MT對衡量視野MD的價值更高;NAION患者的MCT厚度明顯比健康人薄。
[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 鹵27.44 渭 m p 鈮，

本文編號：2363127