Department of Ophthalmology, Grenoble-Alpes University Hospital, Grenoble, France; HP2 Laboratory, Grenoble-Alpes University Hospital, Grenoble, France.
INSERM U1042, and the Quality of Care Unit, CIC 1406 INSERM, Grenoble-Alpes University Hospital, Grenoble, France.
Am J Ophthalmol. 2019 Dec;208:178-184. doi: 10.1016/j.ajo.2019.04.007. Epub 2019 Apr 17.
The pathophysiology of nonarteritic anterior ischemic optic neuropathy (NAION) is not completely understood. Studies of the retinal vasculature phenotype in patients with NAION could help us to understand vascular abnormalities associated with the disease.
Retrospective case series with matched control subjects.
Study population: 57 patients with NAION and 57 control subjects matched to NAION patients for sex, age, systemic hypertension, diabetes, and obstructive sleep apnea syndrome between September 2007 and July 2017.
All patients and control subjects underwent a complete ocular examination and 45° funduscopic color photographs. The widths of the 6 largest arteries in zone B (between 0.5 and 1 optic disc diameter from the optic disc), summarized by the central retinal artery equivalent (CRAE), the widths of the 6 largest veins in zone B, summarized by the central retinal vein equivalent (CRVE), the arteriole to venule ratio, tortuosity, and fractal dimension were measured on the 2 groups using Vessel Assessment and Measurement Platform for Images of the Retina, a software tool for efficient semiautomatic quantification of the retinal vasculature morphology in fundus camera images. The Wilcoxon signed-rank test and MacNemar χ test for paired sample and generalized estimating equations for modeling the Vessel Assessment and Measurement Platform for Images of the Retina parameters as dependent variables were used.
CRVE and fractal dimension (D0a) were significantly higher in the NAION group when compared with the control group, whereas the arteriole to venule ratio and vascular tortuosity were significantly lower. Compared with control subjects, acute NAION yielded an increased CRAE value (174 ± 33 vs 160 ± 13 μm) while resolution NAION yielded a decreased CRAE value (152 ± 12 vs 156 ± 33 μm). Acute NAION yielded an increased CRVE value (244 ± 35 vs 210 ± 21 μm) while resolution NAION yielded an unchanged CRVE value. We found no difference between groups for age, refraction, optic disc diameter, CRAE, or fractal dimension.
Retinal vascular parameters were different in our sample between NAION and control patients, especially at the acute stage of the disease. Our results suggest a normalization of the same parameters at the resolution stage.
非动脉炎性前部缺血性视神经病变（NAION）的病理生理学尚不完全清楚。对 NAION 患者视网膜血管表型的研究可以帮助我们了解与疾病相关的血管异常。
回顾性病例系列研究，匹配对照受试者。
研究人群：2007 年 9 月至 2017 年 7 月，共纳入 57 例 NAION 患者和 57 例与 NAION 患者性别、年龄、系统性高血压、糖尿病和阻塞性睡眠呼吸暂停综合征相匹配的对照受试者。
所有患者和对照受试者均接受全面眼部检查和 45°眼底彩色照相。使用视网膜血管评估和测量平台（一种用于高效半自动量化眼底相机图像中视网膜血管形态的软件工具）测量 B 区（距视盘 0.5 至 1 个视盘直径范围内）6 条最大动脉的宽度，用视网膜中央动脉等效值（CRAE）表示；B 区 6 条最大静脉的宽度，用视网膜中央静脉等效值（CRVE）表示；动静脉比、迂曲度和分形维数。采用 Wilcoxon 符号秩检验和配对样本 MacNemar χ2 检验以及广义估计方程模型对视网膜血管评估和测量平台的参数进行分析。
与对照组相比，NAION 组的 CRVE 和分形维数（D0a）明显较高，而动静脉比和血管迂曲度明显较低。与对照组相比，急性 NAION 患者的 CRAE 值增加（174±33 比 160±13 μm），而缓解期 NAION 患者的 CRAE 值降低（152±12 比 156±33 μm）。急性 NAION 患者的 CRVE 值增加（244±35 比 210±21 μm），而缓解期 NAION 患者的 CRVE 值无变化。两组间年龄、屈光度、视盘直径、CRAE 或分形维数无差异。
在我们的研究中，NAION 患者和对照患者的视网膜血管参数不同，尤其是在疾病的急性期。我们的结果表明，在缓解期这些参数会恢复正常。
