Jonas J B, Harder B
Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany.
Eye (Lond). 2008 Apr;22(4):556-8. doi: 10.1038/sj.eye.6702792. Epub 2007 Mar 23.
Arteritic anterior ischaemic optic neuropathy and nonarteritic anterior ischaemic optic neuropathy are acute optic neuropathies, which have to be differentiated from each other. It was the purpose of this study to assess whether ophthalmodynamometry with an assessment of the collapse pressure of the central retinal artery (CRA) and vein (CRV) is helpful for that. Using a Goldmann contact lens-associated ophthalmodynamometer, the diastolic collapse pressure of the CRA and CRV were measured in six patients (eight eyes) with giant cell arteritis-induced anterior ischaemic optic neuropathy (GC-AION) and in 10 patients (12 eyes) with acute non-arteritic anterior ischaemic optic neuropathy (NAION). CRA collapse pressure was significantly (P=0.001; 95% confidence interval (CI): -68.7, -20.0) lower in the GC-AION group (52.7+/-24.6 arbitrary units) than in the NAION group (97.0+/-25.8 arbitrary units). CRV collapse pressure did not vary significantly (P=0.47). As measured by ophthalmodynamometry, CRA pressure is significantly lower in GC-AION than in NAION. CRV pressure does not vary markedly. These finding may be helpful for the clinical differentiation between GC-AION and NAION, and may give hints for the pathogenesis.
动脉炎性前部缺血性视神经病变和非动脉炎性前部缺血性视神经病变均为急性视神经病变,必须相互鉴别。本研究的目的是评估通过测量视网膜中央动脉(CRA)和静脉(CRV)的塌陷压力进行的眼动脉压测量是否有助于鉴别二者。使用与戈德曼接触镜相关的眼动脉压计,对6例(8只眼)巨细胞动脉炎所致前部缺血性视神经病变(GC-AION)患者和10例(12只眼)急性非动脉炎性前部缺血性视神经病变(NAION)患者的CRA和CRV舒张压塌陷压力进行了测量。GC-AION组(52.7±24.6任意单位)的CRA塌陷压力显著低于NAION组(97.0±25.8任意单位)(P=0.001;95%置信区间(CI):-68.7,-20.0)。CRV塌陷压力无显著差异(P=0.47)。通过眼动脉压测量,GC-AION患者的CRA压力显著低于NAION患者。CRV压力无明显变化。这些发现可能有助于GC-AION和NAION的临床鉴别,并可能为发病机制提供线索。