Smith Andrew K, Bussel Igor, Ling John, Mosaed Sameh
Department of Ophthalmology, University of California, Gavin Herbert Eye Institute, Irvine, California, USA; University of California, Irvine School of Medicine, Irvine, California, USA.
J Curr Glaucoma Pract. 2020 Sep-Dec;14(3):106-108. doi: 10.5005/jp-journals-10078-1284.
To present an association between acquired pits of the optic nerve (APON) and prior laser-assisted keratomileusis (LASIK).
A retrospective case series of patients with an optic disc pit on clinical exam and a history of LASIK. Spectralis Optical Coherence Tomography images and Humphrey Visual Fields were reviewed from prior visits. Extended-depth optical coherence tomography was performed of the optic nerve head at subsequent visits after patients were identified.
Seven patients, aged 45-73 years, were identified each with unilateral optic disc pits. Optic disc pits were located inferior in six patients and centrally in one patient. All demonstrated thinning on optical coherence tomography and six patients had corresponding visual field defects. Four patients identified these defects after their LASIK procedure while two patients were unaware of their reproducible visual field defects. All patients were treated with drops initially. One patient underwent laser trabeculoplasty, and three underwent a trabeculectomy after demonstrating progression on maximum tolerated medical therapy.
This series describes a possible association between LASIK and APON. Given the similarity and severity of vision loss associated with the optic nerve pits in these patients after LASIK, increased awareness and caution is suggested while considering LASIK in susceptible individuals.
Smith AK, Bussel I, Ling J, Acquired Optic Pits Associated with Laser-assisted Keratomileusis: A Case Series. J Curr Glaucoma Pract 2020;14(3):106-108.
探讨获得性视神经凹陷(APON)与既往准分子激光原位角膜磨镶术(LASIK)之间的关联。
对临床检查发现视神经盘凹陷且有LASIK病史的患者进行回顾性病例系列研究。回顾之前就诊时的Spectralis光学相干断层扫描图像和Humphrey视野检查结果。在确定患者后,于后续就诊时对视神经乳头进行增强深度光学相干断层扫描。
共纳入7例患者,年龄45 - 73岁,均为单侧视神经盘凹陷。6例患者的视神经盘凹陷位于下方,1例位于中央。所有患者在光学相干断层扫描中均显示变薄,6例患者有相应的视野缺损。4例患者在LASIK手术后发现这些缺损,而2例患者未意识到其可重复性视野缺损。所有患者最初均接受滴眼液治疗。1例患者接受了激光小梁成形术,3例在最大耐受药物治疗病情进展后接受了小梁切除术。
本系列研究描述了LASIK与APON之间可能存在的关联。鉴于这些患者LASIK术后视神经凹陷相关视力丧失的相似性和严重性,建议在考虑对易感个体进行LASIK手术时提高认识并谨慎操作。
Smith AK, Bussel I, Ling J, 获得性视神经凹陷与准分子激光原位角膜磨镶术相关:病例系列。《当代青光眼实践杂志》2020;14(3):106 - 108。