Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Am J Ophthalmol. 2020 Sep;217:174-181. doi: 10.1016/j.ajo.2020.03.052. Epub 2020 Apr 13.
Optic disc drusen (ODD), present in 2% of the general population, have occasionally been reported in patients with nonarteritic anterior ischemic optic neuropathy (NA-AION). The purpose of this study was to examine the prevalence of ODD in young patients with NA-AION.
Retrospective, cross-sectional multicenter study.
All patients with NA-AION 50 years old or younger, seen in neuro-ophthalmology clinics of the international ODDS (Optic Disc Drusen Studies) Consortium between April 1, 2017, and March 31, 2019, were identified. Patients were included if ODD were diagnosed by any method, or if ODD were excluded by enhanced-depth imaging optical coherence tomography (EDI-OCT) using ODDS Consortium guidelines. NA-AION eyes with ODD were termed "ODD-AION"; those without were termed "NODD-AION".
A total of 65 patients (127 eyes) with NA-AION were included (mean 41 years old). Of the 74 eyes with NA-AION, 51% had ODD-AION, whereas 43% of fellow eyes without NA-AION had ODD (P = .36). No significant differences were found between ODD-AION and NODD-AION eyes in terms of Snellen best-corrected VA or perimetric mean deviation. According to EDI-OCT results, 28% of eyes with NODD-AION had peripapillary hyperreflective ovoid mass-like structures (PHOMS); 7% had hyperreflective lines, whereas 54% with ODD-AION had PHOMS; and 66% had hyperreflective lines (P = .006 and P < .001, respectively).
Most of these young NA-AION patients had ODD. This indicates that ODD may be an independent risk factor for the development of NA-AION, at least in younger patients. This study suggests ODD-AION be recognized as a novel diagnosis.
视盘玻璃膜疣（ODD）在普通人群中的发生率为 2%，偶尔也有报道称其存在于非动脉炎性前部缺血性视神经病变（NA-AION）患者中。本研究旨在探讨年轻 NA-AION 患者中 ODD 的患病率。
回顾性、横断面多中心研究。
所有年龄在 50 岁及以下、在 2017 年 4 月 1 日至 2019 年 3 月 31 日期间在国际 ODD（Optic Disc Drusen Studies）研究协会的神经眼科诊所就诊的 NA-AION 患者均被识别出来。如果通过任何方法诊断为 ODD，或者如果根据 ODD 研究协会的指南使用增强深度成像光学相干断层扫描（EDI-OCT）排除了 ODD，则将患者纳入研究。患有 ODD 的 NA-AION 眼被称为“ODD-AION”；没有 ODD 的则称为“NODD-AION”。
共纳入 65 例（127 只眼）NA-AION 患者（平均年龄 41 岁）。在 74 只 NA-AION 眼中，51%的眼患有 ODD-AION，而 43%的对侧眼没有 NA-AION 但患有 ODD（P=.36）。在 Snellen 最佳矫正视力或视野平均缺损方面，ODD-AION 眼和 NODD-AION 眼之间无显著差异。根据 EDI-OCT 结果，28%的 NODD-AION 眼有神经纤维层旁高反射卵圆形团块样结构（PHOMS）；7%的眼有高反射线，而 54%的 ODD-AION 眼有 PHOMS；66%的眼有高反射线（P=.006 和 P<.001）。
这些年轻的 NA-AION 患者大多数患有 ODD。这表明 ODD 可能是 NA-AION 发展的独立危险因素，至少在年轻患者中如此。本研究表明，ODD-AION 应被视为一种新的诊断。
