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非动脉炎性前部缺血性视神经病变中的脉络膜厚度

Choroidal thickness in nonarteritic anterior ischemic optic neuropathy.

作者信息

Schuster Alexander K, Steinmetz Philippe, Forster Tessa M, Schlichtenbrede Frank C, Harder Björn C, Jonas Jost B

机构信息

Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany.

Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany.

出版信息

Am J Ophthalmol. 2014 Dec;158(6):1342-1347.e1. doi: 10.1016/j.ajo.2014.09.008. Epub 2014 Sep 8.

Abstract

PURPOSE

To examine choroidal thickness in nonarteritic anterior ischemic optic neuropathy (AION).

DESIGN

Retrospective case control study.

METHODS

In the eye clinic of the University Medical Center in Mannheim, Germany, we studied a group that consisted of patients with nonarteritic AION and a control group that consisted of individuals with normal fundus. Choroidal thickness was measured by the enhanced-depth imaging of spectral-domain optical coherence tomography. The main outcome measure was choroidal thickness.

RESULTS

The study group consisted of 20 patients: 11 patients with acute nonarteritic AION and an unaffected contralateral eye and 9 patients with acute unilateral nonarteritic AION and previously nonarteritic AION in the contralateral eye. The control group consisted of 58 patients (58 eyes). In multivariate analysis, thinner subfoveal choroidal thickness was associated with the diagnosis of nonarteritic AION (P = 0.001; regression coefficient B, -55.1), after adjusting for age (P < 0.001) and refractive error (P = 0.20). Similarly, unaffected eyes contralateral to eyes with acute nonarteritic AION as compared to control eyes showed thinner subfoveal choroidal thickness (P = 0.037) after adjusting for age (P = 0.001) and refractive error (P = 0.06). In a reverse manner, nonarteritic AION was associated with thinner subfoveal choroidal thickness (P = 0.007) after adjusting for age, optic disc diameter, gender, and refractive error.

CONCLUSIONS

Eyes affected by nonarteritic AION and unaffected contralateral eyes showed significantly thinner macular choroids than eyes of a control group after adjusting ocular and systemic parameters. A thin choroid may be added to the diagnostic features of nonarteritic AION. Future studies may examine the pathophysiologic meaning of the finding.

摘要

目的

研究非动脉炎性前部缺血性视神经病变(AION)患者的脉络膜厚度。

设计

回顾性病例对照研究。

方法

在德国曼海姆大学医学中心眼科门诊,我们研究了一组非动脉炎性AION患者以及一组眼底正常的对照组。通过光谱域光学相干断层扫描的增强深度成像测量脉络膜厚度。主要观察指标为脉络膜厚度。

结果

研究组包括20例患者:11例急性非动脉炎性AION患者,对侧眼未受累;9例急性单侧非动脉炎性AION患者,对侧眼既往有非动脉炎性AION病史。对照组包括58例患者(58只眼)。多因素分析显示,在调整年龄(P<0.001)和屈光不正(P = 0.20)后,黄斑中心凹下脉络膜厚度变薄与非动脉炎性AION的诊断相关(P = 0.001;回归系数B,-55.1)。同样,在调整年龄(P = 0.001)和屈光不正(P = 0.06)后,急性非动脉炎性AION患者对侧未受累眼与对照眼相比,黄斑中心凹下脉络膜厚度更薄(P = 0.037)。相反,在调整年龄、视盘直径、性别和屈光不正后,非动脉炎性AION与黄斑中心凹下脉络膜厚度变薄相关(P = 0.007)。

结论

在调整眼部和全身参数后,受非动脉炎性AION影响的眼及其对侧未受累眼的黄斑脉络膜厚度明显薄于对照组的眼。脉络膜变薄可能是非动脉炎性AION的诊断特征之一。未来的研究可探讨这一发现的病理生理学意义。

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