Kupersmith Mark J
New York Eye and Ear Infirmary, Mount Sinai Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, New York, New York.
J Neuroophthalmol. 2015 Jun;35(2):210-9. doi: 10.1097/WNO.0000000000000248.
Although we are still early in the evolution of optical imaging of the optic nerve, the available techniques already play an important role in clinical decision making. I would summarize our findings to date as follows: For acute ON: Presentation: OCT shows RNFL swelling, normal GCL + IPL by OCT; 1 month: OCT and SLP show RNFL thinning and swelling, GCL + IPL thinning by OCT; 3 months or later: OCT and SLP show RNFL thinning, further mild GCL thinning by OCT; 6 months: RNFL and GCL + IPL thinning finished. For acute NAION: Presentation: OCT shows RNFL swelling and SLP shows loss of birefringence, normal GCL + IPL by OCT; 1 month: RNFL swelling and thinning by OCT and thinning by SLP, GCL + IPL thinning by OCT; 3 months or later: RNFL and further mild GCL + IPL thinning; 6 months: RNFL and GCL + IPL thinning finished. For IIH Papilledema with mild vision loss: Presentation: OCT shows swelling of RNFL, TRT, and ONH volume; Presentation: OCT shows normal GCL + IPL; Presentation: OCT shows neural canal border inward deflection; 6 months: OCT shows structural shape changes reflecting the effectiveness of treatment.
尽管我们在视神经光学成像的发展方面仍处于早期阶段，但现有的技术已经在临床决策中发挥着重要作用。我将我们目前的研究结果总结如下：对于急性视神经炎：发病时：光学相干断层扫描（OCT）显示视网膜神经纤维层（RNFL）肿胀，OCT显示神经节细胞层（GCL）和内层视网膜神经纤维层（IPL）正常；1个月时：OCT和视觉诱发电位（SLP）显示RNFL变薄和肿胀，OCT显示GCL+IPL变薄；3个月或更晚时：OCT和SLP显示RNFL变薄，OCT显示GCL进一步轻度变薄；6个月时：RNFL和GCL+IPL变薄完成。对于急性非动脉炎性前部缺血性视神经病变（NAION）：发病时：OCT显示RNFL肿胀，SLP显示双折射丧失，OCT显示GCL+IPL正常；1个月时：OCT显示RNFL肿胀和变薄，SLP显示变薄，OCT显示GCL+IPL变薄；3个月或更晚时：RNFL和GCL+IPL进一步轻度变薄；6个月时：RNFL和GCL+IPL变薄完成。对于伴有轻度视力丧失的特发性颅内高压性视乳头水肿：发病时：OCT显示RNFL、视网膜厚度（TRT）和视神经乳头（ONH）体积肿胀；发病时：OCT显示GCL+IPL正常；发病时：OCT显示神经管边界向内偏移；6个月时：OCT显示结构形状变化，反映治疗效果。
