Choi Jae Hwan, Shin Jong Hoon, Jung Jae Ho
Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
J Clin Neurol. 2019 Jul;15(3):386-392. doi: 10.3988/jcn.2019.15.3.386.
The aim of this study is to report the relative incidence of arteritic anterior ischemic optic neuropathy (AAION) associated with giant-cell arteritis (GCA) in a single-center and evaluate the clinical features of AAION in Korean patients.
The medical records of patients with presumed AION who visited our hospital from January 2013 to August 2018 were examined retrospectively. The patients were divided into two groups: AAION associated with GCA, and non AION (NAION). We additionally reviewed the literature and identified all cases of AAION in Korean and Caucasian patients. We evaluated the clinical data including the initial and final best-corrected visual acuities, fundus photographs, visual field tests, fluorescein angiography, and contrast-enhanced MRI, and compared the data with those for Caucasian patients in the literature.
Of the 142 patients with presumed AION, 3 (2.1%) were diagnosed with AAION and 139 (97.9%) were diagnosed with NAION. Seven Korean patients with AAION associated with GCA were identified in our data and the literature review. We found no difference in any clinical features other than laterality: four of the seven Korean patients had bilateral involvement. Moreover, the optic nerve sheath was enhanced in two of our Korean patients.
AAION associated with GCA is a very rare condition compared to NAION in Korea. However, GCA should be considered in all cases of ischemic optic neuropathy because AAION is associated with poor visual outcome, and sometimes presents bilaterally.
本研究旨在报告单中心巨细胞动脉炎(GCA)相关的动脉炎性前部缺血性视神经病变(AAION)的相对发病率,并评估韩国患者AAION的临床特征。
回顾性分析2013年1月至2018年8月来我院就诊的疑似前部缺血性视神经病变(AION)患者的病历。患者分为两组:GCA相关的AAION组和非AION(NAION)组。我们还查阅了文献,确定了韩国和白种人患者中所有AAION病例。我们评估了包括初始和最终最佳矫正视力、眼底照片、视野检查、荧光素血管造影和对比增强MRI在内的临床数据,并将这些数据与文献中白种人患者的数据进行比较。
在142例疑似AION患者中,3例(2.1%)被诊断为AAION,139例(97.9%)被诊断为NAION。通过我们的数据和文献回顾,共确定了7例韩国GCA相关的AAION患者。除了病变侧别外,我们发现其他任何临床特征均无差异:7例韩国患者中有4例为双侧受累。此外,我们的2例韩国患者视神经鞘有强化表现。
在韩国,与NAION相比,GCA相关的AAION是一种非常罕见的疾病。然而,在所有缺血性视神经病变病例中都应考虑GCA,因为AAION与视力预后不良相关,且有时会双侧发病。