Nelson Kiersten, Singh Gurjit, Boyer Stephen, Gay Dax
Veterans Affairs Illiana Health Care System, Danville, Illinois, USA.
Optometry. 2010 Nov;81(11):587-97. doi: 10.1016/j.optm.2010.02.013.
Nonarteritic ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in adults over the age of 50. Patients affected notice sudden and painless loss of vision in 1 eye, often upon awaking. Studies have found that the opposite eye may be affected in approximately 15% to 20% of cases within a 5-year period. NAION vision loss results from an ischemic event often affecting the short posterior ciliary arteries. This results in optic nerve pallor, nerve fiber layer defects, and corresponding visual field defects.
Two cases of NAION are discussed here. The first patient, a 57-year-old woman, had a 10-year history of visual symptoms, and the second, a 66-year-old man, presented in less than a week after first noticing symptoms. Both had predisposing systemic risk factors and resultant visual field loss and decreased visual acuity.
Predisposing factors for NAION include small cup-to-disc ratios of the optic nerve, obstructive sleep apnea, nocturnal hypotension, diabetes, and other vascular diseases. The vision loss is irreversible, and there is no known effective treatment to prevent subsequent disc atrophy or recurring episodes.
非动脉炎性缺血性视神经病变（NAION）是50岁以上成年人中最常见的急性视神经病变。受影响的患者通常在醒来时突然发现单眼无痛性视力丧失。研究发现，在5年时间内，约15%至20%的病例中对侧眼可能会受到影响。NAION导致的视力丧失是由常影响睫状后短动脉的缺血事件引起的。这会导致视神经苍白、神经纤维层缺损以及相应的视野缺损。
本文讨论了两例NAION病例。首例患者为一名57岁女性，有10年视觉症状病史，第二例为一名66岁男性，在首次出现症状后不到一周就诊。两人均有易患的全身危险因素，导致视野缺损和视力下降。
NAION的易患因素包括视神经杯盘比小、阻塞性睡眠呼吸暂停、夜间低血压、糖尿病和其他血管疾病。视力丧失是不可逆的，目前尚无已知有效的治疗方法来预防随后的视盘萎缩或复发。
