Obuchowska Iwona, Mariak Zofia
Kliniki Okulistyki Akademii Medycznej w Białymstoku.
Klin Oczna. 2006;108(4-6):238-42.
Ischemic optic neuropathy is a common cause of visual loss in the older population. This disease is classified into anterior and posterior type according to the location the lesions. The anterior type is due to transient nonperfusion or hypoperfusion of the ciliary circulation in the optic nerve head. The etiology of this disease is multifactorial. The most important risk factors for developing anterior ischemic optic neuropathy (AION) include hypertension, nocturnal hypotension, diabetes mellitus, atherosclerosis and small cup in the optic disc. AION presents with sudden painless loss of vision, pale edema of the optic disc, afferent papillary defect and visual field defects, typically in lower quadrants. Posterior ischemic optic neuropathy (PION) is a rare condition and diagnosis of it usually is made only after other causes of a retrobulbar optic neuropathy have been excluded. There are three distinct subtype of PION: perioperative, arteritic and nonarteritic. They are characterized by acute visual loss, variable visual field defects, relative afferent pupillary defect and normal optic disc.
缺血性视神经病变是老年人群视力丧失的常见原因。根据病变部位，该疾病分为前部型和后部型。前部型是由于视神经乳头睫状循环的短暂无灌注或灌注不足所致。该疾病的病因是多因素的。发生前部缺血性视神经病变（AION）的最重要危险因素包括高血压、夜间低血压、糖尿病、动脉粥样硬化和视盘小视杯。AION表现为突然无痛性视力丧失、视盘苍白水肿、传入性瞳孔障碍和视野缺损，通常在下象限。后部缺血性视神经病变（PION）是一种罕见疾病，通常仅在排除球后视神经病变的其他原因后才能做出诊断。PION有三种不同的亚型：围手术期型、动脉炎性型和非动脉炎性型。它们的特点是急性视力丧失、可变的视野缺损、相对传入性瞳孔障碍和正常的视盘。
